Total Leukocyte Count Research Articles

Pattern of Expression of PML-RARα Transcripts in Acute Promyelocytic Leukemia Patients and Its Correlation with Overall Survival: A Retrospective Study from Western India

Abstract Introduction Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia with specific molecular pathogenesis, clinical features, and treatment. It is cytogenetically characterized by translocation t (15;17) (q24;q21). The location of breakpoints within the PML gene determines the formation of distinct promyelocytic leukemia-retinoic acid receptor α (PML-RARα) transcript subtypes which have prognostic significance. Breakpoints in intron 6 result in the long (L or bcr-1) subtype, those in exon 6 produce the variant (V or bcr-2) subtype, and breakpoints in intron 3 lead to the short (S or bcr-3) subtype. Objectives The aim of our study was to determine the frequencies of the different PML-RARα transcripts in patients with APL at baseline and to investigate the impact of bcr-3 transcript as a prognostic factor on survival in newly diagnosed patients with APL. Materials and Methods A retrospective study was conducted that included 54 newly diagnosed patients with APL. Clinicopathological parameters were evaluated in all cases for prognostic significance with overall survival. Real-time quantitative polymerase chain reaction was used for the quantification of PML-RARα transcripts. Results Out of 54 patients, 53 (98.1%) patients expressed bcr-3 transcript either alone or in combination with either bcr-1 or bcr-2 transcripts. Twenty-one patients (38.9%) in our study showed expression of bcr-3 transcript only. Twenty eight (51.9%) patients in our study expressed all the three transcripts. Out of the 54 patients, 20 (37%) patients died of disease, out of which 19 patients died before completion of induction therapy. Complete remission was obtained in 34 patients (63%) after induction therapy. The survival rate for patients expressing the bcr-3 transcript alone was 66.66% as compared with 60.71% for patients expressing bcr-3 transcript in combination with other two transcripts. The survival rate for patients receiving all-trans retinoic acid (ATRA) in combination with arsenic trioxide was far better than patients receiving ATRA alone. Conclusion The total leucocyte count is an independent prognostic factor in patients with APL as it was statistically significant with overall survival in our study. The bcr transcript either alone or in combination with bcr-1 and/or bcr-2 transcripts was the most frequent pattern observed.

Evaluation of Total Leucocyte Count among Menstruating Female Students Aged 16-30 at Lead City University, Ibadan

Evaluation of Total Leucocyte Count among Menstruating Female Students Aged 16-30 at Lead City University, Ibadan

HEALTH RISK ASSESSMENT IN RURAL WOMEN ON EXPOSURE TO DOMESTIC INDOOR AIR POLLUTION BY COMBUSTION OF BIOMASS FUELS

Biomass fuels, derived from plants and animals, are intentionally burned by humans for various purposes, including cooking. However, the combustion of biomass fuels, such as wood, animal dung, and crop residues, often occurs in open fires, resulting in high indoor and outdoor air pollution. This poses significant health risks, particularly for women and young children. In this study conducted in villages around Meerut city in Western Uttar Pradesh, India, the focus was on rural integrated women's health, specifically those using biomass fuel for cooking. The research included three age groups of women exposed to biomass fuel and a control group using cleaner alternatives like LPG and biogas. Hematological parameters, including hemoglobin, red blood cell count, total leukocyte count, and platelet count, were analyzed to assess the impact of biomass fuel exposure on health. The study involved 180 women from 15 villages, and blood samples were collected to evaluate immunological, hematological, and biochemical parameters. Results indicated that women exposed to biomass fuel exhibited significant alterations in hematological parameters, including lower hemoglobin levels, reduced red blood cell counts, and changes in platelet counts. These findings suggest a potential association between biomass fuel exposure and health issues such as tuberculosis infection, decreased immunity, respiratory disorders, cataracts, liver dysfunction, kidney disorders, and anemia. The study emphasizes the detrimental effects of indoor air pollution from biomass fuel smoke on the health of rural women. The observed alterations in hematological parameters highlight the urgent need for interventions to reduce biomass fuel usage and mitigate health risks in these communities. This research contributes valuable insights into the complex relationship between indoor air pollution and its adverse health effects, particularly among women in rural settings.

Anti-arthritic Effects of Undifferentiated and Chondrogenic Differentiated MSCs in MIA-induced Osteoarthritis in Wistar Rats: Involvement of Oxidative Stress and Immune Modulation.

Osteoarthritis (OA) is a degenerative joint disease that can affect the many tissues of the joint. There are no officially recognized disease-modifying therapies for clinical use at this time probably due to a lack of complete comprehension of the pathogenesis of the disease. In recent years, emerging regenerative therapy and treatments with stem cells both undifferentiated and differentiated cells have gained much attention as they can efficiently promote tissue repair and regeneration. To determine how bone marrow-derived mesenchymal stem cells (BM-MSCs) and chondrogenic differentiated MSCs (CD-MSCs) can treat OA in rats, OA was induced in Wistar rats by injecting three doses of 100 μL physiological saline containing 1 mg of MIA into rat ankle joint of the right hind leg for three consecutive days. Following the induction, the osteoarthritic rats were injected weekly with BM-MSCs or CD-MSCs at a dose of 1x106 cells/rat/dose for three weeks. In addition to morphological and histological investigations of the ankle, spectrophotometric, ELISA, and Western blot analyses were applied to detect various immunological and molecular parameters in serum and ankle. The results of the study showed that in osteoarthritic rats, BM-MSCs and CD-MSCs significantly reduced right hind paw circumference, total leucocyte count (TLC), differential leukocyte count (DLC) of neutrophils, monocytes, lymphocytes, and eosinophils, serum rheumatoid factor (RF), prostaglandin E2 (PGE2) and interleukin (IL-) 1β levels, while they elevated serum IL-10 level. Additionally, BM-MSCs and CD-MSCs markedly reduced lipid peroxides (LPO) levels while they elevated superoxide dismutase (SOD) and glutathione-S-transferase (GST) activities. The monocyte chemoattractant protein-1 (MCP-1) level was significantly downregulated in ankle joint articular tissues by treatment with BM-MSCs or CD-MSCs while nuclear factor erythroid 2-related factor 2 (Nrf2) was upregulated; CD-MSCs treatment was more effective. According to these findings, it can be inferred that BM-MSCs and CD-MSCs have anti-arthritic potential in MIA-induced OA; CD-MSCs therapy is more effective than MSCs. The ameliorative anti-arthritic effects may be mediated by suppressing inflammation and oxidative stress through the downregulation of MCP-1 and upregulation of Nrf2. Based on the obtained results, BM-MSCs and CD-MSCs therapies are promising new options that can be associated with other clinical treatments to improve cartilage regeneration and joint healing. However, more preclinical and clinical research is required to assess the benefits and safety of treating osteoarthritic patients with BM-MSCs and CD-MSCs.

Eosinophilic dermatitis in a patient with chronic lymphocytic leukemia.

Hematological malignancies are known to have cutaneous manifestations, either in the form of direct infiltration of skin by malignant cells or as a result of paraneoplastic syndrome. Many hematological malignancies, including chronic lymphocytic leukemia (CLL), are known to cause malignancy-induced Eosinophilic Dermatoses. We present a case of an elderly woman who presented with multiple pruritic patches. On clinical examination, the patient had multiple enlarged lymph nodes in the cervical and inguinal regions. The total leucocyte count was elevated and peripheral blood examination showed atypical lymphocytes. Flow cytometry was suggestive of CLL. The skin biopsy was suggestive of Eosinophilic Dermatoses in a case of chronic lymphocytic leukemia. We should be aware of this entity as they mimic insect bites, urticaria, and other skin conditions both histologically and clinically and to avoid a diagnostic pitfall.

Angiostrongylus cantonensis Meningo-Encephalitis in Children-Heightened Awareness Needed During Prolonged Wet Weather Conditions.

Angiostrongylus cantonensis, the leading cause of eosinophilic meningoencephalitis, is well established in eastern Australia. Prolonged wet weather in Queensland during 2021-2022 coincided with anecdotal reports of increased neuroangiostrongyliasis cases, prompting an evaluation of paediatric cases from 2013 to 2022. This retrospective observational study reviewed children (0-16 years) with cerebrospinal fluid (CSF) eosinophilia (≥ 10% of the total CSF leukocyte count) and/or A. cantonensis testing (serology or polymerase chain reaction) between 01/01/2013 and 31/12/2022, using statewide laboratory data and patient records. Eighty children were identified: 59 (74%) had CSF eosinophilia without A. cantonensis testing, 9 (11%) had CSF eosinophilia with A. cantonensis testing, and 12 (15%) had A. cantonensis testing without CSF eosinophilia. Neuroangiostrongyliasis was either proven or probable in seven children: five (71%) during 2021-2022, coinciding with prolonged wet weather. A significant positive correlation was observed between rainfall and case numbers (r = 0.88, p < 0.01). Median age of diagnosed children was 4 years (IQR 1.8-8.5, range 1.5-13 years) and five (71%) were male. Snail or slug exposure was reported in four (57%) children. All children presented with vomiting, and six also had a headache and focal neurology (86%). Abnormal neuroimaging was noted in six (86%) cases. Five children received corticosteroid therapy alone (71%), while two (29%) were managed conservatively. There were no deaths, but one child had persistent focal neurological abnormalities at discharge. Awareness of A. cantonensis and exposure risks is crucial, especially during prolonged wet weather conditions. While most children in this study had good outcomes, this is not always the case.

DYNAMICS OF ALTERATIONS IN WHITE BLOOD CELL AND SEPSIS-ASSOCIATED HUMORAL FACTORS DURING SULFUR MUSTARD INTOXICATION

Introduction. Sulfur mustard (SM) is an important chemical warfare agent. Lack of antidote and pathogenetic means in the arsenal of modern medicine for the treatment of SM poisoning requires further studies on the pathogenesis and development of protective medical devices and treatment schemes. The aim is to assess the features of immune response and intestinal bacterial translocation during SM intoxication. Materials and methods. The experiments were performed with Chinchilla male rabbits. SM was injected to laboratory animals intramuscularly at a dose of 63mg/kg, amounting to 1.0 LD84. The test materials presented by blood samples collected by cardiac puncture and from the lateral ear vein. Cardiac blood was used to produce serum and subsequently to determine the level of the sepsis-associated humoral factors (lipopolysaccharide, sCD14, procalcitonin, tumor necrosis factor a, interleukins 6 and 10) by using enzyme-linked immunosorbent assay. Results. In the peripheral blood of rabbits there were found changes characterized by decreased total leukocyte count, a development of lymphocytopenia and monocytopenia, as well as two-phase granulocyte count dynamics. The blood leukocyte formula showed the most significant changes related to three cell subsets: segmentonuclear neutrophils, lymphocytes and plasmocytes. The analysis of blood serum for assessing level of the sepsis-associated humoral factors showed that the earliest pathobiochemical change was related to higher sCD14. On day 2 post-exposure, a simultaneous increase in the levels of tumor necrosis factor a, interleukins 6 and 10 was reported. The cytokine level was decreasing to baseline range starting from day 3 onwards, whereas the clinical manifestation of SM intoxication was increasing and reaching the maximum magnitude. The analysis of blood serum for lipopolysaccharide level showed its increase on day 3 and 4 post-exposure. Conclusion. The study data in the context of the proposed interpretation, allow to highlight the following phasing of pathological changes during an extremely severe SM intoxication: day 1 - myeloid phagocytic system activation and hyperphagocytosis; day 2 - systemic inflammatory and compensatory anti-inflammatory response syndromes; days 3-4 - «immune paralysis», intensified bacterial translocation, depletion of the endotoxin-binding system and «endotoxin aggression».

Assessment of the Severity of Intermediate Coronary Artery Stenosis Using the Systemic Inflammatory Response Index.

Background: Fractional Flow Reserve (FFR) is a method that enables the hemodynamic assessment of coronary artery stenosis. The Systemic Inflammatory Response Index (SIRI) is a new marker calculated by multiplying the neutrophil-to-lymphocyte ratio (NLR) with the monocyte count. It is indicative of the presence and severity of coronary artery disease. This study evaluates the relationship between the functional significance of FFR measurements and the SIRI in intermediate coronary stenosis. Methods: A total of 294 patients with 50-70% stenosis in their coronary arteries based on quantitative measurement following angiography who underwent FFR measurement were included in the study before the FFR procedure. Total and differential leukocyte counts and routine biochemical tests were performed. Results: A total of 37% of the patients were found to have a positive FFR, while 63% had a negative FFR. Significant differences were observed in the neutrophil count, monocyte count, Systemic Inflammation Response Index (SIRI), total cholesterol, and amount of adenosine used between the groups (p < 0.05). A SIRI value of 1.16 was 77% sensitive and 55% specific for FFR positivity. Multivariate logistic regression analysis identified the SIRI as an independent predictor of FFR positivity. Conclusions: Our study has demonstrated that high values of the SIRI may serve as a new biomarker for predicting FFR positivity.

Rebound tonometry intraocular pressure reference values for conscious adult Egyptian vultures (Neophron percnopterus).

To obtain standard reference values of intraocular pressure measured with rebound tonometry in conscious healthy Egyptian vultures (Neophron percnopterus). 17 Egyptian vultures presented for a routine health check, involving a full physical examination, blood film examination, Hct, manual total leukocyte count, and plasma biochemistry. 15 animals considered healthy and with no signs of stress underwent an ophthalmic examination, including observation of facial symmetry, adnexa, and direct fundoscopy to screen for ocular disease. Healthy animals, with no evidence of ocular disease and no signs of stress, were included in the study. The birds were manually restraint in an upright position for rebound tonometry of the right and left eyes. Mean and SD of intraocular pressure were 27.33 ± 3.54 mm Hg for the right eye and 27.00 ± 4.11 mm Hg for the left eye. There was no statistical difference when comparing the right and left eyes. The combined mean ± SD for both eyes was 27.2 ± 3.76 mm Hg. Rebound tonometry was well tolerated in all animals included in the study. The results of intraocular pressure with rebound tonometry can be used as reference values during the ophthalmological examination of Egyptian vultures. The investigation of vision threatening diseases in Egyptian vultures may necessitate rebound tonometry as part of a comprehensive ophthalmologic examination. Rebound tonometry values obtained from anesthetized Egyptian vultures, or Egyptian vultures restrained in lateral, dorsal, or sternal positions, may differ from those reported here.

From cell to organ: Exploring the toxicological correlation of organophosphorus compounds in living system.

Malathion is an organophosphate compound widely used as an insecticide in the agriculture sector and is toxic to humans and other mammals. Although several studies have been conducted at different levels in different animal models. But there is no work has been conducted on the toxicological correlation from cellular to behavioral level in surviving species model. Addressing this gap through further research is essential for a comprehensive understanding of malathion's impact on biological systems, facilitating better risk assessment and management strategies. Current research systemically evaluated the effects of malathion on the central nervous system and peripheral immune cells using immunological techniques in the BALB/c mice models. For this, animals were placed inside an inhalation chamber containing malathion (dose of 89.5 mg/ml/m3) for a specific exposure time. The group exposed for 6 minutes has shown a significant change in plasma-neurotransmitter (serotonin, dopamine) levels and decreased expression of Tyrosine hydroxylase in striatum and SNPC region of brain. The depolarized mitochondria and increased level of cleaved caspase-3 level and mature neurons in DG, CA1 and CA3 were also observed in the brain. Peripheral blood analysis illustrated a decrease in total leukocyte count and an increased level of early apoptosis at the same time point. From neurobehavioral results a significant locomotor hyperactivity, restlessness, and risk-taking behavior was observed. Taken together, results from the current study indicate that exposure to malathion at prolonged time durations induces neuronal and immune cell toxicity, and its toxicity may be mediated via changes in neurotransmitter levels and metabolite concentrations.

A Neonate Presenting With Large Abdominal Mass: A Rare Case of Congenital Leukemia.

Leukemia symptoms occurring in the first 4 weeks of infancy are known as congenital leukemia. We present a case of congenital leukemia in a full-term neonate manifesting at birth with a grossly distended abdomen due to a large abdominal mass. Ultrasonography of the abdomen showed a large abdominal mass originating from the liver. Congenital leukemia was suspected based on the very high total leukocyte counts and the presence of blast cells in the peripheral blood smear, which was confirmed by bone marrow aspiration. The bone marrow aspirate smear showed 42% blast cells. Due to overwhelming sepsis, the baby died at the neonatal intensive care unit on day 4 after birth. This report highlights the atypical presentations of congenital leukemia in the neonatal period.

Aberrant Expression of CD Markers in Acute Leukemia with Hematological Parameters Correlation: A Single Center Experience

ABSTRACT Background: Immunophenotyping by flowcytometry improves both the accuracy and reproducibility of an acute leukemia (AL) diagnosis. The morphologically similar blast cells can be easily differentiated by immunophenotyping based on expression and different CD (cluster of differentiation) markers. It also plays a crucial role in the identification of aberrant antigens. The present study was conducted to determine the frequency of aberrant phenotypes in newly diagnosed cases of acute leukemia and its correlation with hematological parameters. Methods: We retrospectively investigated the phenotype of blast cells from 72 patients with acute leukemia diagnosed over a one and half year period. Diagnosis of acute leukemia was based on morphology, cytochemistry, and immunophenotyping by flow cytometry. Results: Out of the total 72 cases of Acute leukemia, 40 (55.6%) cases showed aberrant expression. 12/27 cases (44.4%) of AML and 28/45 cases (62.2%) of ALL showed aberrant phenotypes in the present study. Aberrant expression of CD7, 6/27 cases (22.2%) was very frequent in AML. Among the ALL cases, CD13, 14/45 cases (31.1%) were most commonly expressed. The mean total leukocyte count (TLC) and percentage of blasts in peripheral blood were significantly higher in AML and ALL cases with aberrant phenotypes as compared to their conventional phenotypes with no aberrancy. Conclusions: It is of clinical importance to detect aberrant phenotypes for accurate diagnosis and when looking for minimal residual disease during morphologic remission. In addition, aberrant phenotypes in AML and ALL cases are associated with unfavorable hematological features in our study.

Ovine Toxoplasmosis Sero-Status, Risk Factors Analysis, and Estimation of Haematological and Serum Biochemical Alterations.

Toxoplasmosis is a significant food-borne protozoal disease in humans and animals. The study aimed to find out Toxoplasma seropositivity in sheep, estimate epidemiological risk factors and assess haemato-biochemical parameter changes. Blood samples were collected from 276 indigenous sheep in five districts surrounding Sulaymaniyah Province in the northern region of Iraq. Toxoplasmosis was determined by detecting anti-Toxoplasma antibodies by ELISA. The impact of various risk factors on seropositivity was evaluated. Haematological and serum biochemical changes from naturally infected sheep were analysed using commercial kits. The overall seroprevalence of Toxoplasma antibodies among the studied population was 41.67%. Sharazoor district had a higher prevalence rate of 46.15% than Bakrajo, with the lowest frequency rate of 38.18%. Ewes with an abortion history had a higher risk for seropositivity of about 47.4% (OR=1.4, 95% CI: 0.9-1.6). Sampling season and herd size are other risk factors, with higher seropositivity at 42.5% (OR=1.1, 95% CI: 0.8-1.4) during the dry season and among small flocks ≤100 animals/farm at 43.6% (OR=1.1, 95% CI: 0.7-1.4). Toxoplasma prevalence was correlated with animals' ages; a higher seropositivity of 43.3% was found among older sheep (OR=0.8, 95% CI: 0.6-1.2). Seropositive sheep had significantly higher total leukocyte, lymphocyte and granulocyte counts but significantly lower haemoglobin, haematocrit and total erythrocyte counts. The serum levels of total protein and albumin were significantly reduced, with increased blood urea nitrogen and creatinine concentrations. Also, AST enzyme activity represents a higher value in positive sheep with toxoplasmosis. Toxoplasma infection among the ovine population is common. Its impact on livestock productivity should not be neglected. A potential risk for humans through infected sheep could be a hazardous source for public health.

Anti-asthmatic and antioxidant activity of flavonoids isolated from Mentha longifolia subspecies typhoides (Briq.) Harley. and Mentha longifolia subspecies schimperi (Briq.) Briq. on ovalbumin-induced allergic asthma in mice: In-vivo and in-silico study.

Mentha longifolia L. has been employed to treat cough, lung inflammation, and bronchial asthma disorders. Our study was carried out to investigate the medicinal effect of the flavonoids derived from M. longifolia, specifically didymin, linarin, rutin, and TMF, as well as the whole extracts of M. longifolia subsp. typhoides and M. longifolia subsp. schimperi, in comparison to dexa, in a mice model of ovalbumin-allergic asthma (OVA). After inhaling OVA, the mice developed acute asthma symptoms. Mice were subjected orally to Dexa and/or isolated flavonoids. The study assessed total and differential leukocyte counts, LDH concentration, and total protein concentration in BALF, reduced levels of GSH and total NOx products in lung tissues and analyzed the lung specimens by staining them with hematoxylin and eosin (H & E). Histopathological analysis of the right lung lobes demonstrated that the isolated flavonoids exhibited a significant anti-inflammatory effect higher than Dexa as shown by decreasing the overall and distinct leukocyte counts, LDH levels, and total protein levels in BALF, as compared to the OVA group (p<0.05). TMF was the most effective and the other tested flavonoids are more effective than Dexa but less than TMF. In addition, all tested flavonoids and Dexa significantly (p<0.05) mitigated OVA-induced oxidative stress as evidenced by diminished lung NOx level and elevated GSH level. Computational docking studies proved recognition of didymin, linarin, rutin, and TMF to the human leukocyte elastase binding sites. The tested flavonoids; didymin, linarin, rutin, and TMF successfully inhibit Ova-induced allergic asthma in mice through their anti-inflammatory and antioxidant activities and may represent promising candidate as a remedy for allergic asthma.

Thyroid Dysfunction in Patients With End-Stage Renal Disease: A Single-Centered Experience From Pakistan.

Introduction The global prevalence of chronic kidney disease (CKD) is increasing due to diabetes and hypertension, with a substantial number of patients progressing to end-stage renal disease (ESRD) requiring maintenance dialysis. Thyroid dysfunction, particularly hypothyroidism, is common in CKD and ESRD patients but is often underdiagnosed due to symptom overlap with uremia. This study aimed to determine the prevalence of thyroid dysfunction in hemodialysis patients at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Methods A prospective cross-sectional study was conducted, enrolling 131 patients on maintenance hemodialysis for at least three months. Participants' demographic and clinical data were collected, and blood samples were taken for thyroid function testing using an Access hypersensitive thyroid-stimulating hormone (hTSH) immunoassay system. Statistical analyses were performed using SPSS version 22.0(IBM Corp., Armonk, NY), with a significance threshold of p < 0.05. Results The total population included in the study was 131. Out of them, 74 (56.5%) were males. The study population had a mean age of 56.4 years. Hypertension and diabeteswere the most common comorbidities noticed in 73 (55.7%) and 14 (10.7%) patients, respectively.Hypothyroidism was observed in 27 (20.6%) patients, with 18 (66.7%) of them having overt hypothyroidism. Hyperthyroidism was observed in four (3.1%)patients, all subclinical. Significant risk factors for hypothyroidism included female gender, longer duration on hemodialysis, decreased total leukocyte and platelet counts, and increased serum urea and creatinine levels. Conclusion The study underscores the significant burden of thyroid dysfunction in ESRD patients on hemodialysis, emphasizing the need for regular screening and management to mitigate associated cardiovascular risks and improve patient outcomes. Future studies should explore the long-term benefits of routine thyroid screening and the impact of different dialysis modalities on thyroid function.

Ethyl caffeate modulates systemic and mucosal immune responses, growth performance, and disease resistance against Vibrio parahaemolyticus in hybrid grouper (Epinephelus fuscoguttatus ♀ × E. lanceolatus ♂).

Hybrid groupers become one of the important aquatic animals, but gastric pathogen infection causes losses due to Vibrio sp. infections. Ethyl caffeate (EC), a naturally occurring antioxidant and antibacterial derived from medicinal plant. This study investigated the effects of EC on the immune response, growth performance, as well as the systemic and mucosal immunity following Vibrio parahaemolyticus challenge. The hybrid groupers were fed diets containing EC at the concentrations of 0, 0.1, 0.25, and 0.5 g/kg (control, EC0.1, EC0.25, and EC0.5 groups, respectively). This feeding trial was conducted in three-part separate experiments consist of non-specific immune response, growth performance and challenge test experiment. The result demonstrated that the EC0.25 group had the highest total leukocyte count, phagocytic activity, and respiratory burst (O2-) and the highest upregulation of genes related to antioxidant activity, inflammation, antimicrobial peptides, and stress. Furthermore, higher growth performance was observed in all EC groups than in the control group with the EC0.25 group exhibited optimum growth performance. According to the challenge test results, the EC0.25 group exhibited strong resistance to V. parahaemolyticus, with a survival rate of 96.7%. This study elucidated a novel self-defense mechanism after EC modulating against V. parahaemolyticus challenge in hybrid groupers. The EC0.25 group had increased leukocyte subpopulation and the highest upregulation of Toll-like receptor 4, Toll-like receptor 21, MyD88, major histocompatibility complex II, immunoglobulin M, interleukin-1β, and tumor necrosis factor-α in both systemic and mucosal related-organs. Overall, dietary EC0.25 increased the hybrid groupers' health status, activated multiple signaling pathways, and synergistically increased the host's systemic and mucosal immunity.

Profile and resistance pattern of Stenotrophomonas maltophilia in Dr. Soetomo General Academic Hospital During 2020-2022 Period

Introduction: Stenotrophomonas maltophilia is a challenging respiratory tract pathogen with increasing number of cases. S. maltophilia also shows a high resistance towards various antibiotics. The aim for this study is to know the antibiotic resistance pattern and profile of patient infected with S. maltophilia in order to find out effective antibiotic therapy in treating future cases. Methods: This cross-sectional study uses descriptive analytic method using medical record data of 36 patients infected with S. maltophilia in Dr. Soetomo General Academic Hospital during 2020-2022 period. The measured variables included antibiotic resistance pattern, age, sex, clinical diagnosis, comorbidity, signs and symptoms, medical device usage, total leukocyte count, and mortality rate. Result: S. maltophilia shows highest sensitivity index towards Trimetophrim-sulfomethoxazole (56%). Cases of S. maltophilia is most often found in 0-17 years age group (53%) and male (63%). It may cause infection whether alone or alongside other bacteria. The most common clinical diagnosis that occurs in S. maltophilia infections is pneumonia (81%). Dyspnea is the most occurred symptoms. Hypertension is a common comorbidity. IV infusion is the most used medical device. Might cause infection alongside other bacteria. Leukocytosis is often present. Mortality rate among subjects is 50%. Conclusion: Trimetophrim-sulfomethoxazole is the best treatment for S. maltophilia infections. Cases most often occurs in age 0-17 years, male, diagnosed with pneumonia, and has hypertension as comorbidity. In the future, antibiotics must be used wisely to prevent bacterial resistance and regular changing of medical device is encouraged to prevent nosocomial infections.

Effect of The Garlic as Chelation Therapy in Reducing Lead and Cadmium Deposition on Suckling Mice

The study was conducted on suckling mice to determine the effects of chelation therapy in reducing the deposition of lead (Pb) and cadmium (Cd). A total of 45 suckling mice were randomly divided into three main groups A (control), B, and C. Groups B and C contained Pb and Cd, respectively, at a concentration of 100 mg/kg bwt with 0, 1.70, 3.35, and 6.70% garlic given (B1, B2, B3, B4, and C1, C2, C3, C4). Mice exposed to Pb and Cd exhibited pronounced toxic symptoms along with a marked decrease in total erythrocyte and total leukocyte count, hemoglobin levels, and packed cell volume. Additionally, there is a significant increase in serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT) levels. The mean body weight of mice of groups B4, and C4 was the highest among the treated groups. Groups B1 and C1, exposed to Pb and Cd without garlic, showed significant declines in all parameters. Group A (control) shows stable and normal SGOT and SGPT levels. Group C1, exposed to Cd without garlic, experiences the highest increases in both SGOT (98.53 U/L) and SGPT (132.83 U/L), indicating severe liver damage. The group treated with Pb and Cd showed a significant reduction in total erythrocyte count, packed cell volume, and hemoglobin levels after 42-d of treatment. However, mice treated with a combination of Pb, Cd, and 6.70% garlic exhibited nearly normal levels of hematological and biochemical parameters. SGPT and SGOT levels were significantly decreased in all treated groups along with garlic. This experiment demonstrates that garlic possesses both protective and curative effects against Pb and Cd toxicity.

Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis.

Despite treatment with antibiotic therapy, spontaneous bacterial peritonitis (SBP) accounts for approximately 20-40% mortality in hospitalized patients. The data is scarce regarding mortality predictors in SBP. Recently, multiple factors have been studied for effectiveness in prognosis prediction in SBP. Therefore, in this study, our main objective was to evaluate the mortality predictors in SBP. This prospective observational study was conducted at the Department of Hepatogastroenterology, from January 2022 to June 2023. All the patients aged between 18 and 65 years having decompensated chronic liver disease and diagnosed with SBP were enrolled in the study. The excluded population comprised of those who were on hemodialysis, those having history of any solid organ malignancy or transplantation or patients suffering from infections such as those caused by human immunodeficiency virus (HIV) or infections other than SBP. These patients were followed during the hospital stay and after the discharge monthly for 3 months and then at 6 months to assess mortality. A total of 142 cirrhotic patients having SBP were enrolled in the study. Among them, most of them were males [98 (69%)]. Viral hepatitis (65.4%) was the most common cause of cirrhosis in studied population. On univariate analysis, serum total leukocyte count (TLC), international normalized ratio (INR), ascitic TLC, ascitic neutrophils, ascitic lactate, ascitic LDH, CTP score, MELD-Na were significantly higher while serum albumin was significantly lower in the patients who died as compared to those who survived. However, on multivariate cox regression analysis, high serum TLC (p = 0.013), ascitic fluid lactate (p < 0.001) along with high CTP (p = 0.041) and MELD-Na score (p = 0.037) at presentation were the factors that were identified as an independent poor prognostic factors in SBP population. Cirrhotic patients with SBP are at increased risk of mortality. In our study we observed that high prognostic scores such as CTP and MELD-Na at presentation along with increased white blood cell counts and high ascitic fluid lactate levels at presentation are the potential and reliable predictors of mortality in SBP patients. Kumar D, Kumar V, Khan RTY, et al. Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis. Euroasian J Hepato-Gastroenterol 2024;14(2):125-128.

EFFECTS OF MELATONIN AS ADJUVANT THERAPY IN TREATMENT OF NEONATAL SEPSIS

Background: Neonatal sepsis is a critical concern, causing significant morbidity and mortality, especially in preterm and low-birth-weight infants. Traditional treatments, including antibiotics and supportive care, often fall short in reducing high mortality rates, emphasizing the need for effective adjunct therapies. Melatonin, known for its antioxidant and anti-inflammatory properties, may offer therapeutic benefits by modulating immune responses and mitigating oxidative stress in neonatal conditions. Objective: This study evaluates the effectiveness of melatonin as an adjunct therapy in neonatal sepsis, focusing on improvements in clinical and laboratory outcomes. Methods: In this randomized controlled trial conducted at the Department of Neonatology at Children Hospital, PIMS, Islamabad from September 1, 2023, to February 28, 2024, 60 neonates diagnosed with sepsis were divided into two groups. The experimental group (Group A) received 20 mg of enteral melatonin in addition to standard care, while the control group (Group B) received standard care alone. Key metrics such as sepsis scores, C-reactive protein (CRP) levels, and complete blood counts were assessed at baseline and 48 hours post-treatment. Results: Significant improvements were observed in the melatonin group, with sepsis scores decreasing from an average of 12.2 ± 3.1 to 6.1 ± 1.8, CRP levels reducing from 12.5 mg/ml to 6.5 mg/ml, and total leukocyte counts dropping from 12,500 cells/µL to 9,800 cells/µL. The control group showed lesser improvements across these parameters. Conclusion: Melatonin shows potential as an adjunct treatment in neonatal sepsis, effectively reducing inflammation and enhancing clinical outcomes. Further research is needed to substantiate these findings and integrate melatonin into broader clinical practices.