Decrease In Hemoglobin Concentration Research Articles

Molecular Epidemiology of Coronavirus Disease and its Effect on the Hematological Profile in District Kech, Balochistan

The coronavirus disease (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study aimed to investigate the occurrence of COVID-19 in district Kech, associated risk factors, clinical presentation, and its effect on blood cells. A structured questionnaire was designed to collect the data and the samples were investigated by RT-PCR. In total, 575 suspects were screened, among which 64 (11.16%) had COVID-19 infection, 40.6% were males, and 59.4% were females. An increased positivity of 53.12% was measured in the younger age group (15-30 years) and the lowest (18.75%) was noticed in elders > 50 years. 95.3% of the patients were newly infected, and 7.7% had a contact history with COVID-19-infected patients. The clinical symptoms, such as fever, cough, nausea, vomiting, and diarrhea, were identified in 89.1%, 67.2%, 51.6%, 46.9%, and 12.5%, respectively. The prominent clinical features, like fever, cough, nausea, diarrhea, chest distress, chest pain, and psychological stress were observed. Noticeably, 10.9% of obesity and 7.8% of asthma patients were co-infected with COVID-19 disease including 39.1% of cases showed psychological trauma. Leucocytosis and a decrease in hemoglobin concentration and platelets were determined in COVID-19-infected patients. A significant effect was observed on the hematological profile, however, the effect was severe in the older age group (>50 years). The results suggest that the large population of the study area is infected by SARS-CoV-2, appealing to the need for surveillance on a large scale and the implementation of preventive measures to control further dissemination of the disease.

Endoscopic manifestation of intestinal transplant-associated microangiopathy after stem cell transplantation

BackgroundEndoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic characteristics of patients diagnosed with iTAM.MethodsThis retrospective analysis included 14 patients pathologically diagnosed with iTAM after stem cell transplantation for hematolymphoid neoplasms (n = 13) or thalassemia (n = 1). The sex, age at diagnosis, endoscopic features, and prognosis of each patient were assessed. Serological markers for diagnosing transplant-associated thrombotic microangiopathy were also evaluated.ResultsThe mean age at the time of iTAM diagnosis was 40.2 years. Patients diagnosed based on the pathognomonic pathological changes of iTAM presented with diverse symptoms at the times of endoscopic examinations, including diarrhea (n = 10), abdominal pain (n = 5), nausea (n = 4), appetite loss (n = 2), bloody stools (n = 2), abdominal discomfort (n = 1), and vomiting (n = 1). At the final follow-up, six patients survived, while eight patients succumbed, with a median time of 100.5 days (range: 52–247) post-diagnosis. Endoscopic manifestations included erythematous mucosa (n = 14), erosions (n = 13), ulcers (n = 9), mucosal edema (n = 9), granular mucosa (n = 9), and villous atrophy (n = 4). Erosions and/or ulcers were primarily observed in the colon (10/14, 71%), followed by the ileum (9/13, 69%), stomach (4/10, 40%), cecum (5/14, 36%), duodenum (3/10, 30%), rectum (4/14, 29%), and esophagus (1/10, 10%). Cytomegalovirus infection (n = 4) and graft-versus-host disease (n = 2) coexisted within the gastrointestinal tract. Patients had de novo prolonged or progressive thrombocytopenia (6/14, 43%), decreased hemoglobin concentration (4/14, 29%), reduced serum haptoglobin level (3/14, 21%), and a sudden and persistent increase in lactate dehydrogenase level (2/14, 14%). Peripheral blood samples from 12 patients were evaluated for schistocytes, with none exceeding 4%.ConclusionsThis study provides a comprehensive exploration of the endoscopic characteristics of iTAM. Notably, all patients exhibited erythematous mucosa throughout the gastrointestinal tract, accompanied by prevalent manifestations, such as erosions (93%), ulcers (64%), mucosal edema (64%), granular mucosa (64%), and villous atrophy (29%). Because of the low positivity for serological markers of transplant-associated thrombotic microangiopathy in patients with iTAM, endoscopic evaluation and biopsy of these lesions are crucial, even in the absence of these serological features.

Association of ambient air pollution with hemoglobin levels and anemia in the general population of Korean adults

BackgroundEmerging evidence has suggested significant associations between ambient air pollution and changes in hemoglobin levels or anemia in specific vulnerable groups, but few studies have assessed this relationship in the general population. This study aimed to evaluate the association between long-term exposure to air pollution and hemoglobin concentrations or anemia in general adults in South Korea.MethodsA total of 69,830 Korean adults from a large-scale nationwide survey were selected for our final analysis. Air pollutants included particulate matter with an aerodynamic diameter less than or equal to 10 micrometers (PM10), particulate matter with an aerodynamic diameter less than or equal to 2.5 micrometers, nitrogen dioxide, sulfur dioxide (SO2), and carbon monoxide (CO). We measured the serum hemoglobin concentration to assess anemia for each participant.ResultsIn the fully adjusted model, exposure levels to PM10, SO2, and CO for one and two years were significantly associated with decreased hemoglobin concentrations (all p < 0.05), with effects ranging from 0.15 to 0.62% per increase in interquartile range (IQR) for each air pollutant. We also showed a significant association of annual exposure to PM10 with anemia (p = 0.0426); the odds ratio (OR) [95% confidence interval (CI)] for anemia per each increase in IQR in PM10 was estimated to be 1.039 (1.001–1.079). This association was also found in the 2-year duration of exposure (OR = 1.046; 95% CI = 1.009–1.083; adjusted Model 2). In addition, CO exposure during two years was closely related to anemia (OR = 1.046; 95% CI = 1.004–1.091; adjusted Model 2).ConclusionsThis study provides the first evidence that long-term exposure to air pollution, especially PM10, is significantly associated with reduced hemoglobin levels and anemia in the general adult population.

MARKERS OF COMPLICATIONS AFTER LAPAROSCOPIC GASTRIC BYPASS IN PATIENTS WITH OBESITY

Introduction. Bariatric surgery is one of the most effective methods of treating morbid obesity, which allows for a long-lasting result. Along with the increase in the number of operative methods of obesity treatment, the relevance of issues related to postoperative complications is increasing. In recent years, the issue of using special checklists after surgery has been actively investigated. This will help optimize the process of monitoring patients' condition in the postoperative period.&#x0D; The aim of the study: to develop a check-list model to prevent the detection of complications after laparoscopic gastric bypass in obese patients.&#x0D; Materials and methods. On the basis of the developed checklist, a study of the condition of obese patients, who underwent laparoscopic gastric bypass during 2019-2023, was conducted on the basis of the Department of General Surgery No. 2 of the Bogomolets National Medical University. The checklist included the following criteria: the level of pain on the VAS scale, the level of nausea, eating, mobility, whether there is a desire to be discharged home, abdominal muscle tension, pain in the calf muscles, heart rate, oxygen saturation in the blood, the number drainage discharge within 24 hours, temperature, systolic blood pressure, central venous pressure, laboratory diagnosis, decrease in hemoglobin concentration, leukocyte level after surgery, C-reactive protein level after surgery, blood procalcitonin level, erythrocyte sedimentation rate level, the presence of a shift in the leukocyte formula to the left. The presence of complications was assessed, the parameters of the checklist were analyzed using univariate logistic regression and ROC analysis for early detection of complications and determination of the chance of complications in the future.&#x0D; Results. Complications occurred in 18/218 (8.2%). The most frequent complication was bleeding in 6/18 (33.3%). Reoperation was performed in 12 cases of 12/18 (66.6%), endoscopic treatment was performed in 1 case, and conservative methods were used in 5 cases. According to the checklist, 31.81% had a positive predictive value (PPV) and 99.56% had a negative predictive value (NPV). The optimal cut-off point of the total score of the checklist was 6. Patients with a positive prognosis of the checklist have a higher chance of developing complications of VSH – 4.5 (95% CI 1.8-9.72), p &lt;0.001.&#x0D; Conclusions. The complication rate was 18/218 (8.2%). According to the checklist, heart rate, systolic blood pressure and mobility are very good predictors of postoperative complications. The checklist is the best option for determining the readiness of patients to be discharged from the hospital due to a high prognostic negative result. Due to the low prognostic positive result, the evaluated checklist needs additional modification and optimization taking into account the results already obtained.

The Effect of Albumin Administration in Critically Ill Patients: A Retrospective Single-Center Analysis.

The aim of this study was to analyze the development of albumin administration in patients admitted to the adult ICU. In addition, we assessed the impact of albumin administration on serum hemoglobin concentration. We conducted a retrospective single-center study including all patients who were admitted to the ICU from January 2013 to December 2021 and stayed at least 24 hours. The study was conducted in an academic hospital (University Hospital Basel, Switzerland). A total of 20,927 admissions were included, of which 3748 received albumin at least once during their ICU stay. To analyze volume expansion, 2006 admissions met the inclusion criteria, namely at least two hemoglobin measurements within 12 hours, one albumin delivery, and experienced no bleeding, dialysis, or transfusions during this period. None. We examined the hemoglobin levels before and after albumin administration and compared them with a matched control group to assess the amount and duration of volume expansion. From 2013 to 2021 the proportion of critically ill patients treated with albumin rose from 5.0% to 32.5%. An overproportioned increase in albumin use could be seen in surgical patients (4.7-47.2%) and in those receiving RBC transfusion (13.7-72.6%). In those patients receiving albumin, a significant drop in hemoglobin of around 5 g/L on average could be observed following treatment with albumin. Hemodilution was observable for at least 12 hours after albumin administration and may have caused a decrease in hemoglobin concentration of greater than 8 g/L when isooncotic albumin solution (5%, 25 g in 500 mL) was administered. This makes albumin, especially in its isooncotic form, an ideal colloid to achieve long-lasting volume expansion. However, RBC transfusions may increase under albumin therapy, as transfusion thresholds may be undershot after albumin administration.

Anemia in Pregnancy: Cause and Effect

One of the most common complications associated with pregnancy is anemia. Severe anemia that occurs during pregnancy has adverse effects on both the mother and the fetus. This literature review aims to provide related information related to how anemia can occur in pregnancy, what are the risk factors and causes of anemia in pregnancy, and the impact of anemia on pregnant women and their fetuses. We searched from online databases and used review articles, research, guidelines from professional organizations, such as World Health Organization and Ministry of Health Republic of Indonesia. Result: In general, pregnant women will experience a decrease in hemoglobin concentration due to the physiological role of hemodelution during pregnancy. However, this condition will be worsened and make pregnant women fall into anemia when accompanied by other factors such as iron deficiency, folic acid deficiency, infection, non ideal BMI (Body Mass Index), and congenital blood diseases. As a result, severe anemia that occurs during pregnancy has adverse effects on both the mother and the fetus. Conclusion: It is important to understand the factors that cause anemia in pregnancy to avoid adverse effects on pregnant women and their fetuses or children.

CBFA2T3 affects red blood phenotype in the blood clam Tegillarca granosa by regulating hemocyte proliferation

The red blood phenotype of blood clam Tegillarca granosa, is tightly linked to its health conditions and nutritional benefits, making it an economically important trait. Despite its significance, the molecular regulatory mechanisms responsible for red blood phenotype variation in blood clams still poorly understood. Our previous study shows that hemocyte proliferation may affect hemoglobin concentration (HGC) and cause the red blood phenotype variation in T. granosa. Thus, we defined total hemocyte counts (THC) and HGC as red blood-related traits. In this research, we discovered that blood clams with higher THC exhibited elevated HGC and a darker blood color. To gain insights into the genes associated with THC in T. granosa, we conducted RNA-Seq analysis. Our transcriptome analysis identified 682 genes exclusively highly expressed in high THC clams (HTHC:THC ≥ 15.5 × 104 cells/mL), and 709 genes highly expressed in low THC clams (LTHC:THC ≤ 6.5 × 104 cells/mL). Furthermore, the weighted gene co-expression network analysis (WGCNA) revealed that the grey60 module exhibited significant positive correlations with THC and HGC, implying an association of this module with the red-blood phenotype. Subsequently, the red blood-related module exhibited a significant positive correlation with gill tissue, providing an alternative perspective to support the hypothesis that gills serve as the primary hematopoietic organ in T. granosa. By employing differential expression analysis and WGCNA, CBFA2T3, TAL1, and FLI1 are potentially key genes involved in the regulation of hemocyte proliferation and differentiation. RNA interference of CBFA2T3 gene led to a remarkable decrease in HGC and THC in T. granosa, resulting in a lighter blood color. EdU staining further confirmed the decrease of cell proliferation activity in the gills of T. granosa after knockdown of CBFA2T3. This study enhances our apprehending of the molecular mechanisms in red blood phenotype variation in T. granosa, and potential contributes to the selection breeding of high THC blood clams.

Operative Repair of Type A Aortic Dissection in Jehovah’s Witnesses: Insights From a Case Series

BackgroundJehovah’s Witnesses are known to refuse allogeneic blood products. Consequently, many surgeons will decline to perform aortic surgery on this patient group, given their higher risk. We present here a case series describing operative repair of type A aortic dissection without the use of allogeneic blood products. MethodsFrom 2018 to 2021, 6 Jehovah’s Witness patients underwent open repair of type A aortic dissection. We reviewed preoperative characteristics, diagnostic workup, operative technique, and postoperative outcomes. We also looked specifically at use of autologous whole blood, Cell Saver (Haemonetics) transfusion, synthetic clotting factors (recombinant factor VIIa), and albumin and prothrombin complex concentrate when allowed. ResultsModified hemiarch replacement was performed with the branched single-anastomosis frozen elephant trunk repair (B-SAFER) technique in 4 patients; 2 patients received a standard hemiarch replacement. Aortic valve replacement was performed in 2 patients; root replacement was performed in 1 patient. There were no immediate postoperative coronary complications, strokes, or instances of renal failure. Average decrease in hemoglobin concentration after surgery was 2.3 ± 1.5 g/dL (mean ± SD). Thirty-day mortality was 0. Five of 6 patients survived to discharge, and all survivors to discharge were still alive at the time of submission. ConclusionsBloodless aortic dissection repair in these rare patients can be performed safely in specialized centers using the techniques described. Furthermore, we believe that these techniques can be applied to the general population of patients undergoing emergent cardiac operation to avoid allogeneic transfusions.

The outcome of central nervous system hemangioblastomas in Von Hippel-Lindau (VHL) disease treated with belzutifan: a single-institution retrospective experience.

Belzutifan is a Hypoxia Inducible Factor 2-alpha inhibitor approved in 2021 by the FDA for the treatment of renal cell carcinoma (RCC) in patients with Von-Hippel Landau (VHL) disease. These patients can also present with central nervous system (CNS) hemangioblastomas (HBs). We aim to study the effectiveness and adverse effects of belzutifan for CNS HBs, by reporting our preliminary institutional experience. We present a series of VHL patients with CNS HBs undergoing treatment with belzutifan for RCC. All the included patients met the RECIST inclusion criteria. The clinical and radiological outcome measures included: Objective response rate (ORR), time-to-response (TTR), adverse events (AE), and patient response. Patient response was classified as partial response (PR), complete response (CR), progressive disease (PD), or stable disease (SD). Seven patients with 25 HBs were included in our study. A belzutifan dose of 120mg/day PO was administered for a median of 13 months (range 10-17). Median follow up time was 15 months (range 10-24). An ORR of 71% was observed. The median TTR was 5 months (range: 1-10). None of the patients showed CR, while 5 patients (71.4%) showed PR and 2 (28.5%) showed SD. Among patients with SD the maximum tumor response was 20% [increase/decrease] of the lesion diameter. All the patients experienced decreased hemoglobin concentration, fatigue, and dizziness. None of the patients experienced severe anemia (grade 3-4 CTCAE). Belzutifan appears to be an effective and safe treatment for CNS hemangioblastoma in VHL patients. Further clinical trials to assess the long-term effectiveness of the medication are required.

Efforts To Prevent Adolescent Anemia Through Giving Soy Milk And Dates

Anemia is a decrease in the capacity of the blood to carry oxygen due to a less than normal number of red blood cells or a decrease in hemoglobin concentration which can be caused by a decrease in the production of red blood cells or a lot of blood loss. Anemia in Indonesia is generally caused by iron deficiency, so it is more often called iron deficiency anemia. Anemia is a condition in which a person has a hemoglobin (Hb) level of &lt;13g/dL for males or &lt;12g/dL for females. This disease is the highest cause of disability in the world. The aim of this activity is to prevent anemia through giving soy milk and dates to anemic young women at Baitul Hikmah Tempurejo Vocational School, Jember. The method of delivering health education is carried out by means of a question and answer discussion to all respondents. The results of community service activities have provided education to young women through lectures, checking Hb levels, discussing the importance of preventing anemia. The responses generated by the respondents were enthusiastic enough to be understood by teenagers. This is evidenced by the questions and answers from the respondents. A screening test for hemoglobin (Hb) levels was carried out. From the results of the examination, not all adolescents with normal Hb levels, some were in the anemia category, the hemoglobin level was checked using an electric detection device. Treatment has been given by giving date soy milk to adolescents with anemia, then re-evaluation was carried out and the results showed an increase in Hb levels.

Carbetocin versus Oxytocin with or without Tranexamic Acid for Prophylactic Prevention of Postpartum Hemorrhage after a Vaginal Delivery: A Randomized Clinical Trial

Objective: Our study’s primary objective was to examine the effects of four different prophylactic protocols on the prevention of postpartum hemorrhage following vaginal birth, including carbetocin only, oxytocin only, and a combination of carbetocin or oxytocin with tranexamic acid. Design: A multicentric randomized controlled trial. Participants/Materials, Setting, and Methods: This multicentric center prospective randomized controlled trial was conducted at the Department of Obstetrics and Gynecology of Bezmialem University and Van Health Teaching and Research Hospital from August 2022 to January 2023. The collected data included age, gravidity, parity, gestational age at birth, duration of delivery stages, prepartum hemoglobin and hematocrit concentrations, changes in hemoglobin and hematocrit concentrations, intrapartum blood loss, estimated blood loss after 2 h of vaginal delivery, Apgar scores at 1 and 5 min, birth weight, and neonatal intensive care unit (NICU) admission. Intrapartum blood loss was objectively measured in milliliters using a postpartum drape with a calibrated bag. The amount of bleeding was measured by subtracting the empty weight of the pads placed under the patient in the patient’s bed within 2 h after delivery. Group I: carbetocin 100 μg/mL (n = 75), group II: oxytocin 5 IU/mL (n = 75), group III: carbetocin and tranexamic acid 50 mg/mL (n = 75), group IV: oxytocin and tranexamic acid (n = 75). Results: The hemoglobin concentration decrease significantly differed between groups (1.03 ± 1.04, 1.3 ± 0.85, 1.4 ± 0.85, 1.41 ± 0.87, respectively; p < 0.001). Group 4 has the highest decrease in hemoglobin and hematocrit concentrations. When we investigated the subgroup differences, the decrease in hemoglobin concentration was significantly higher in group 2 than group 1 (1.30 ± 0.85 vs. 1.03 ± 1.04; p = 0.023), in group 2 than group 3 (1.3 ± 0.85 vs. 1.04 ± 0.9; p = 0.013), and in group 4 than group 3 (1.41 ± 0.87 vs. 1.04 ± 0.9; p < 0.001). The decrease in hematocrit level was significantly different between groups (3.07 ± 3.23, 3.55 ± 2.44, 2.13 ± 3.09, 4.25 ± 2.52; p < 0.001, respectively). No significant differences were observed in terms of mean blood loss between the four groups (277.19 ± 208.10, 294.13 ± 198.64, 274.33 ± 199.57, and 283.97 ± 178.11; p = 0.445, respectively). Furthermore, there was no significant difference between the groups in the rate of need for blood transfusion (1.3%, 5.4%, 4%, and 4%, respectively; p = 0.6). Limitations: The most important limitation of the study is a relatively small number of participants. Conclusion: In conclusion, our findings suggest that carbetocin may be more successful than oxytocin and oxytocin plus tranexamic acid regimens in terms of postpartum hemoglobin reduction, and there is no difference in terms of the need for blood transfusion when it is used for postpartum hemorrhage prophylaxis after vaginal delivery.

Giant thoracic hematoma post-transradial coronary angiography: a case report and review of the literature

BackgroundAlthough there are cardiac interventional procedures, certain transradial access complications might be life-threatening.Case presentationA 67-year-old male was admitted for coronary angiography due to chest tightness and shortness of breath on exertion. Hours after the right transradial access angiography, the patients complained the right side of chest pain. Emergent chest X-ray revealed a giant mass in the right chest. The right radial artery was reaccessed and subsequent arteriograms confirmed that the presence of a rupture of the branch of right internal mammary artery. Simultaneously, a microcoil was implanted to seal the perforation. The perforation caused a thoracic hematoma measuring 13.8 cm × 6.7 cm, along with a decrease in hemoglobin concentration from 14.1 g/dL to a minimum of 7.8 g/dL. Additionally, the drainage of the hematoma and red blood cells transfusion were carried out. Further, the patient underwent ascending aortic replacement, aortic valve replacement, mitral valve replacement, and thoracic hematoma removal. Postoperative echocardiography showed that the prosthetic valves were properly positioned and functioning normally. The patient recovered well after the surgery and remained event-free during the latest 14moth follow-up period.ConclusionsVascular perforation and subsequent hematoma might occur due to guidewire maneuvering during transradial approach. Awareness of prevention, early recognition and management of access complications may help reduce the occurrence and severity of complications related to the transradial approach.

Clinical analyzes and theoretical calculations of the characteristics of blood cells in patients with lymphoblastic leukemia

Lymphoblastic leukemia is one of the serious diseases of the hematopoietic system, which requires long-term treatment, but despite this, it often leads to disability and mortal-ity. In this regard, all the still unexplored relationships between blood elements and their motor ability, which can be described by the rheological properties of blood, are of inter-est. For a better understanding of the relationship between morphometric features and the rheological properties of blood, we compiled a research algorithm, the purpose of which was to study the rheological parameters of the blood system using clinical tests and in silico calculations against the background of the clinical picture of the number and size of formed elements, lymphocytic formula of patients with lymphoblastic leuke-mia. In the group of patients with leukoblastic leukemia, the number of neutrophils was reduced by 38% compared with the control. Other types did not change significantly. Thrombocytopenia, a decrease in hemoglobin concentration and hematocrit were ob-served, however, the number of erythrocytes corresponded to the values in the control. The dynamics of the size of erythrocytes is an indicator of the lability of the blood sys-tem. Under conditions of development of leukemic processes, the proportion of young erythroid forms is negligible. The development of lymphoblastic leukemia was accompa-nied by thrombocytopenia, a decrease in hemoglobin concentration and hematocrit, however, the number of erythrocytes corresponded to the values in the control. Studies have revealed changes in the geometric characteristics of erythrocytes in patients with leukemia. The increase in overall dimensions (diameter and height) of erythrocytes in patients with patients with leukoblastic leukemia varied by 15–20 % compared with the control. The rheological parameters were changed significantly. According to our data, the violation of blood flow occurs due to changes in erythrocyte aggregation, deformabil-ity of the erythrocyte membrane, plasma viscosity with an unchanged number of erythro-cytes, i.e. with normal hematocrit. These data are especially interesting from the point of view of rheology and clinic of leukemias.

Sodium Salicylate as Feed Additive in Broilers: Absence of Toxicopathological Findings.

Antimicrobial growth promoters (AGPs) in animal production have been related to the increase in multidrug-resistant bacteria. The AGP ban in many countries has highlighted the growing need for alternatives for feed additives. Considering the non-antibiotic anti-inflammatory theory of AGPs, chicks received three different doses of sodium salicylate (SS) in feed (10, 30, 90 mg/kg), basal diet (BD) was used as a negative control, and zinc bacitracin (ZB) was used as a positive control. Chicks were individually housed to increase the accuracy of the dose of SS ingested. Performance parameters and footpad dermatitis were evaluated weekly, while haematology, serum biochemistry, histopathology, and tibial dyschondroplasia were determined on Days 21 and 42. A linear dose-dependent decrease in haemoglobin concentration was observed, but the values were within the normal reference range. Among all the other evaluated parameters, no relevant differences between treatments were observed; however, not even the AGP group performed better than the control group. It is possible that the conditions in which the birds were raised were not stressful enough to allow for anti-inflammatories to demonstrate their beneficial effects on performance. Studies should be conducted where the animals are exposed to commercial conditions, as the presence of natural stressors could allow a better evaluation of the efficacy of the anti-inflammatory agent as a growth promoter.

Comparison of revascularization with conservative medical treatment in maintenance dialysis patient with coronary artery disease: a systemic review and meta-analysis.

The primary cause of death among maintenance dialysis patients is coronary artery disease (CAD). However, the best treatment plan has not yet been identified. The relevant articles were retrieved from various online databases and references from their inception to October 12, 2022. The studies that compared revascularization [percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)] with medical treatment (MT) among maintenance dialysis patients with CAD were selected. The outcomes evaluated were long-term (with a follow-up of at least 1 year) all-cause mortality, long-term cardiac mortality, and the incidence rate of bleeding events. Bleeding events are defined according to TIMI hemorrhage criteria: (1) major hemorrhage, intracranial hemorrhage or clinically visible hemorrhage (including imaging diagnosis) with decrease of hemoglobin concentration ≥5 g/dl; (2) minor hemorrhage, clinically visible bleeding (including imaging diagnosis) with a drop in hemoglobin of 3-5 g/dl; (3) minimal hemorrhage, clinically visible bleeding with hemoglobin drop <3 g/dl. In addition, revascularization strategy, CAD type, and the number of diseased vessels were considered in subgroup analyses. A total of eight studies with 1,685 patients were selected for this meta-analysis. The current findings suggested that revascularization was associated with low long-term all-cause mortality and long-term cardiac mortality but a similar incidence rate of bleeding events compared to MT. However, subgroup analyses indicated that PCI is linked to decreased long-term all-cause mortality compared to MT but CABG did not significantly differ from MT in terms of long-term all-cause mortality. Revascularization also showed lower long-term all-cause mortality compared to MT among patients with stable CAD, single-vessel disease, and multivessel disease but did not reduce long-term all-cause mortality among patients with ACS. Long-term all-cause mortality and long-term cardiac mortality were reduced by revascularization in comparison to MT alone in patients undergoing dialysis. Larger randomized studies are needed to confirm the conclusion of this meta-analysis.

Some aspects of the control of the reproduction function in female sturgeon fishes

Two series of experiments on the effect of E-selenium on the reproductive function of sturgeons were conducted with different ways of introducing the drug into the body: through feed and injection. The effectiveness of the action of E-selenium was shown in two experiments. First, its ability to accelerate the process of maturation of oocytes was revealed due to the stimulation of generative metabolism and bringing it into line with the stages of the sexual cycle based on the biochemical parameters of the blood. An increase in the concentration in the blood by 1.4 times by the end of the 50-day experiment of total protein and beta-lipoproteins, which include ovovitelin (vitellogenin) during the period of vitellogenesis, as well as a moderate increase in haemoglobin concentration, indicates an increase in generative metabolism. It was noted that the metabolism of control fish was directed to somatic growth to a greater extent than that of experimental fish, as a result of which the average weight of females in control was 1.5 times higher than in the first series of experiments and weight of experimental fish was the same and increased by 6% in power in the second series. The role of the drug as a stabilizer of the physiological state of females, due to its high antioxidant properties, has been noted. When used, the existing signs of a stress state disappear, in contrast to the control fish in which they are detected: an increased cholesterol level, an erythrocyte sedimentation rate (ESR), and a decrease in haemoglobin concentration. The most significant effect from the use of the drug was obtained when the feed was irrigated with E-selenium, in which the number of mature fish after 50 days of the experiment was 2.7 times greater than in control, with a simultaneous halving of immature fish. In the case of the injection of females with this preparation, the number of fish at the IV stage of gonadal maturity in the experimental group after 50 days increased by 1.7 times. In the control group, on the contrary, it decreased by 1.2 times, with a constant proportion of females by the III stage of gonadal maturity.

Biochemical and mineral status of the body of infertile boars with hypovitaminosis A

A leading role in the occurrence of infertility in male domestic animals is played by nutritional deficiency factors, in particular vitamin A deficiency, which contributes to the development of morphological and functional changes in the reproductive system. The aim of the work was to determine the effect of vitamin A (carotene) deficiency on the biochemical and mineral status of infertile boars, in particular, to establish changes in the main biochemical markers and assess the state of the antioxidant defence system and indicators of mineral homeostasis (Calcium, Phosphorus, Zinc, Copper, Manganese and Cobalt). In the experimental group of animals, a probably low level of vitamin A was noted (by 54.2 % lower than the control group, P ˂ 0.001) due to a significant increase in the content of thiobarbiturate acid-reactive compounds (by 2.32 times, P ˂ 0.001) and a decrease in the activity of catalase and superoxide dismutase (by 47.3 % and 28.8 %, respectively, P ˂ 0.001). A decrease in haemoglobin concentration by 14.3 % (Р ˂ 0.001), total protein by 11.6 % (Р ˂ 0.01), the number of erythrocytes by 9.3 % (Р ˂ 0.01) and acid capacity by 9.1 % (Р ˂ 0.05). These results demonstrate a general decrease in metabolic processes in the body of infertile boars with vitamin A deficiency. The reduced number of erythrocytes in the blood of boars of the experimental group was mainly due to antiradical and antihypoxic abilities. It should be noted that catalase activity and the content of reduced glutathione in erythrocytes were probably lower than the control indicators by 53.1 % and 16.3 % (Р ˂ 0.001), respectively. In addition, taking into account the reduced indicators of haemoglobin content and the number of erythrocytes, a negative dynamics of oxygen metabolism was established. This is also confirmed by a probable increase in the content of 2,3-diphosphoglycerate in erythrocytes (by 67.5 %, Р ˂ 0.001). Also, in boars of the experimental group, the content of Calcium was lower by 25.0 % (Р ˂ 0.001) than the control indicators, and the content of Phosphorus decreased by 12.6 % (Р ˂ 0.05). Similar changes were observed in the levels of Zinc and Copper (indicators were lower than the control by 52.0 % and 28.0 %, respectively, Р ˂ 0.001). Note that the Manganese content in the blood of experimental boars was reduced by 20.9 % (Р ˂ 0.05), while the Cobalt level was lower by 16.1 % (Р ˂ 0.05). The obtained results showed a significant effect of A-vitamin deficiency on the general antioxidant activity and mineral homeostasis in barren boars.

Detection of Blood Parasites in Fish

Fish are often infected with different blood protozoa of the genera Babesiosoma, Trypanosoma, and Hemogrigarina. These blood parasites match the genera which infect the blood of mammals. A total of 120 samples from five different fish species (Barbus grypus, Barbus sharpyi, Liza abu, Carasobarbus luteus, and Aspius vorax) were collected from the Khazar River in Ninevah Governorate, Iraq at weekly intervals during the period from April 2022 to October 2022 for the detection of blood parasites and hematological analysis. Thin and thick Giemsa stained blood smears revealed significant infection with Trypanosoma, Babes iosoma, and Haemogregarina which were recorded in 32%, 16%, and 8% of Carasobarbus luteus samples, respectively; 30%, 15%, and 10% of B. sharpyi samples, respectively; and 23.3%, 16.7%, and 6.7% of B. grypus samples, respectively. No infection with Trypanosoma or Babesiosoma were recorded in L. Abu, and no infection with Babesiosoma or Haemogregarina were recorded in A. vorax. Hematological parameters of blood samples from infected fish showed a significant decrease in hemoglobin concentration, total red blood cells, and stacked cell size along with a significant increase in the number of inflammatory cells including lymphocytes, eosinophils, and basophils. This is the first study to identify blood parasites in fishes and to monitor the changes of hematological parameters in blood samples of infected fishes from the waters of Mosul, Iraq.

Study of some epidemiological aspects and heamatological parameters associated with cutaneous leishmaniasis in Tikrit city

This study aimed to estimate the epidemiological prevalence of cutaneous Leishmaniasis, and it's distribution rate in Tikrit and affiliated towns and villages according to patients that attending Tikrit Teaching Hospital. This study recorded 531 cases of infections during the period from October 2011 till the end of September 2012. The results showed that the highest peak of infection was in December (35.59 %) , and infection in male was 50.66 % which was higher than female (49.34%). As well as the highest percentage of infection was represent in the age group under five years (47.65%). Also, the survey showed the higher percentage of infection was in the center of Tikrit city with 43.50 % and followed by towns and villages that affiliate to the city. This study also aimed to know the effect of cutaneous Leishmaniasis on some aspects of hematological parameters. In which the study recorded significant decrease in mean of packed cell volume (PCV) (36.57 ± 1.32، 34.73 ± 1.10) in males and females, respectively, compared with control (l(41.75 ± 1.45 ، 39.86 ± 1.10 in males and females, (respectively). Also, decrease in concentration of hemoglobin (Hb) (11.54 ± 0.41 , 10.97 ± 0.34) in both of males and females, respectively was recorded when they compared with control (13.13 ± 0.43 ، 12.56 ± 0.32 ) in male and females, (respectively). There are significant increased in the total count of white blood cells in both infected males and females (10750 ± 1251 , 9618 ± 935) was recorded when compared with control (6829 ± 655 , 9294 ± 1027 ) in male and females, (respectively).

Evaluation of subacute toxicity of a polyherbal nootropic formulation in Wistar albino rats

In ayurvedic system of traditional medicine, 'medhyarasayanas' — decoction of selected plants are used to improve intellect or cognition abilities. Here, we investigated one such polyherbal formulation (PHF) with ingredients Bacopa monniera, Glycyrrhiza glabra, Valeriana wallechii and Withania somnifera used as a facilitator of learning, retention and recall. We evaluated the safety of this PHF in animal models. We performed acute oral toxicity test using 2000 mg/kg of the formulation as per OECD guideline 423 and observed for toxicity over 14 days. Thereafter, we divided them into four groups of six animals each and administered Normal saline 5 mL/kg, The PHF (Wilmer®) @500, 1000 and 2000 mg/kg in the respective groups over 28 days. We observed no mortality or physical and behavioural abnormalities in both acute and subacute toxicity study. On the 28th day, animals were sacrificed, blood collected for estimation of haematological and biochemical parameters and histopathological examination of organs was performed. There was significant difference (P &lt;0.05) in Mean ± SEM values of haemoglobin, total cholesterol, total protein, ALT, AST, ALP and serum creatinine in the test groups compared to control as analysed by One-way ANOVA followed by Tukey’s multiple comparison test. We observed steatosis and ballooning of hepatocytes, lymphocytic periglomerular infiltrate, eosinophilic hyaline casts and renal tubular coagulation necrosis in histopathology of test groups. Haematologic abnormalities (decrease in haemoglobin concentration), hepatotoxic, nephrotoxic and dyslipidemic effects of the tested PHF were seen in the rats in subacute toxicity study over 28 days, which could be due to the individual plant products, microbial contamination or heavy metals in the formulation in excess of regulatory limits. Hence, it needs further safety evaluation in animals and humans.