Differential Leukocyte Counts Research Articles

Altered leukocyte pattern and inflammatory markers in unvaccinated long covid patients: a cross-sectional study.

Long Covid results from the damage caused by SARS-CoV-2, involving the release of cytokines and the continuous activation of immune cells. This cross-sectional study investigates leukocyte and cytokine profiles in Long Covid patients in the Amazon, a region where such studies are limited. Blood samples were analysed for differential leukocyte counts and cytokine levels. We suggest elevated lymphocyte counts in hospitalised patients and those with severe COVID-19. Higher eosinophil counts were observed in patients with up to three months of Long Covid, and increased monocyte counts in those with up to six months. IL-2 levels were higher in patients with fewer symptoms and Long Covid duration of more than three months, whereas IL-10 may remain elevated for up to 12 months. We suggest positive correlations between neutrophils, monocytes, eosinophils, and lymphocytes with different cytokines (IFN-γ, IL-6, IL-4, IL-17a, IL-2). Women were associated with lower hospitalisation rates and longer durations of Long Covid; increased lymphocyte counts were linked to hospitalisation due to COVID-19, while higher monocyte counts were associated with Long Covid durations of up to six months. We suggest that Long Covid patients may exhibit alterations in inflammatory markers, indicating a persistently pro-inflammatory microenvironment that tends to diminish after 12 months of Long Covid.

Vernonanthura tweediana (Baker) H. Rob. (Asteraceae), an Ordinary Bush or an Anti-Inflammatory and Immunomodulator Aromatic Species?

Background: Oral traditional knowledge disseminates the use of young leaves of Vernonanthura tweediana (Asteraceae) as poultice in feverish cases among family farmers in Santa Catarina, Brazil, but there is a lack of phytochemistry and pharmacological studies on this species, especially those related to volatile organic compounds. Methods: In the present study, the dry leaves of V. tweediana were subjected to hydrodistillation for the extraction of essential oil. Sample characterization was conducted using GC-FID and GC-MS. To evaluate anti-inflammatory and immunomodulatory activities, the air pouch method was used, and with the exudate obtained, total and differential leukocyte counts were performed, as well as the quantification of total proteins, interleukin (IL) 1β, IL-6, and tumor necrosis factor (TNF). Results: The essential oil yield extraction was 0.13%, and sesquiterpenes were the main constituents: α-copaene (5.1%), β-caryophyllene (27.77%), α-caryophyllene (15.1%), germacrene D (14.0%), and bicyclogermacrene (13.3%). A sample was subjected to biological tests, with a reduction in leukocyte migration to the inflammatory focus. The immunomodulatory activity was also pronounced, as the oil modulated all cytokine secretions measured when compared to the control. The high concentration of caryophyllenes might explain these findings. Conclusions: Future studies will consider the fractionation of the essential oil to establish the degree of synergism between the constituents.

Immunomodulatory Potential of Melatonin in Immunosuppression: An in-vivo Study.

To assess the immunomodulatory effects of melatonin on the acquired immunity of immunosuppressed male Wistar rats by checking Interleukin 6 (IL-6) levels, total leucocyte counts (TLC), and differential leucocyte counts. Experimental study. Place and Duration of the Study: Animal laboratory, CMH Lahore Medical College, from June to October 2023. Fifty male Wistar rats, weighing 180g to 200g, were included in this study with 10 rats in each of the five groups namely cyclophosphamide (CP), CP + melatonin, CP + immunomodulator, melatonin-only, and control. A calculated dose of CP was administered intraperitoneally for 30 days (from 13/06/23 to 13/07/23) to each group except the control groups. After this, the experimental group was given melatonin CP + Melatonin for 7 days (from 14/07/23 to 20/07/23). CP + Immunomodulatory group was kept for comparison of immunomodulatory effects. Blood samples were drawn from all 5 groups. IL-6 was estimated through ELISA. Other parameters assessed were TLC and absolute differential leucocyte counts. Melatonin increased IL-6 levels significantly (p = 0.042) as well as the TLC levels (p <0.001) compared to the immuno-suppressed CP group. Melatonin was seen to have an upregulation of IL-6 levels in immunosuppression compared to the administration of immunomodulator preparation (p = 0.506) which was not as effective. Administration of melatonin significantly increased the TLC, neutrophil, lymphocyte, monocyte, and eosinophil count compared to known immunomodulators. Melatonin as a supplement may have some role in activating multiple immune response processes in immune-depressed states. It was also established that it allows quick recovery of cell components from immunosuppressed states. Melatonin, Immunomodulation, Rats, Interleukin-6, Acquired immunity, Cyclophosphamide.

Immunomodulatory Potential of Melatonin in Immunosuppression: An in-vivo Study.

To assess the immunomodulatory effects of melatonin on the acquired immunity of immunosuppressed male Wistar rats by checking Interleukin 6 (IL-6) levels, total leucocyte counts (TLC), and differential leucocyte counts. Experimental study. Place and Duration of the Study: Animal laboratory, CMH Lahore Medical College, from June to October 2023. Fifty male Wistar rats, weighing 180g to 200g, were included in this study with 10 rats in each of the five groups namely cyclophosphamide (CP), CP + melatonin, CP + immunomodulator, melatonin-only, and control. A calculated dose of CP was administered intraperitoneally for 30 days (from 13/06/23 to 13/07/23) to each group except the control groups. After this, the experimental group was given melatonin CP + Melatonin for 7 days (from 14/07/23 to 20/07/23). CP + Immunomodulatory group was kept for comparison of immunomodulatory effects. Blood samples were drawn from all 5 groups. IL-6 was estimated through ELISA. Other parameters assessed were TLC and absolute differential leucocyte counts. Melatonin increased IL-6 levels significantly (p = 0.042) as well as the TLC levels (p <0.001) compared to the immuno-suppressed CP group. Melatonin was seen to have an upregulation of IL-6 levels in immunosuppression compared to the administration of immunomodulator preparation (p = 0.506) which was not as effective. Administration of melatonin significantly increased the TLC, neutrophil, lymphocyte, monocyte, and eosinophil count compared to known immunomodulators. Melatonin as a supplement may have some role in activating multiple immune response processes in immune-depressed states. It was also established that it allows quick recovery of cell components from immunosuppressed states. Melatonin, Immunomodulation, Rats, Interleukin-6, Acquired immunity, Cyclophosphamide.

Comparative Profiling of Milk Somatic Cells Proteomes Revealed Key Players in Mammary Immune Mechanisms During Mastitis in Tropical Sahiwal (Bos indicus) Cows.

Bovine mastitis poses a significant economic burden on the dairy industry worldwide. This pioneering proteomic study conducted a comparative profiling of milk somatic cell (SC) proteins contributing to mammary immune defense during subclinical and clinical mastitis (CM) in Sahiwal (Bos indicus) cows. Based on California mastitis test (CMT) scores, milk SC counts, differential leukocyte counts (DLCs), and bacteriological culture results, quarter milk SC samples were categorized into healthy (H), subclinical mastitis (SCM), and CM groups. Comparative proteome profiling of milk SCs was done using a label-free liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) proteomic approach. The identified upregulated proteins in mastitis groups such as Vanin 2, Thioredoxin reductase-like selenoprotein T, Ceramidase, Lymphocyte antigen 75, Misshapen-like kinase 1 (MINK1), Thrombospondin 1, Macrophage scavenger receptor 1, Leupaxin, and Lipoamide acyltransferase, involved in immune responses. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed immune functions and pathways like antigen processing, complement cascades, extracellular matrix receptor interaction, efferocytosis, leukocyte migration, chemokine, peroxisome proliferator-activated receptors (PPARs), and transforming growth factor (TGF)-beta signaling. These findings provide essential information on proteomic profiling in milk SCs and contribute valuable insights into immune-related proteins regulated during mastitis in dairy cows. Further, validated proteins (Vanin 2, MINK1, and Thrombospondin 1) offer potential inflammatory biomarkers for early mastitis detection in dairy cows.

Evaluation of the Diversities in the Inflammatory Responses in Cats With Bacterial and Viral Infections.

Understanding the nature of inflammatory responses in cats with bacterial and viral infections is essential for accurately managing the infection. This study aimed to investigate the diversities of inflammatory responses between bacterial and viral infections in cats to figure out their role in the pathophysiology of these infections. Seventy-five owned cats were included in the study. The evaluations were performed based on three groups: healthy control, bacterial infection group (those with bronchopneumonia and gastrointestinal tract and urinary tract infections) and viral infection group (21 with feline coronavirus [FCoV], 3 with feline leukaemia virus [FeLV] and 1 with feline calicivirus), each containing 25 individuals. Total and differential leukocyte counts, C-reactive protein (CRP), transforming growth factor beta (TGF-β), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-10 (IL-10) concentrations were assessed in the blood samples collected from sick and healthy animals. No statistically significant difference was noted in serum TNF-α, IL-1β and IL-10 concentrations of the infected cats (p=0.996, p=0.160 and p=0.930, respectively). Serum TGF-β concentration in the viral infection group was reduced compared to the healthy control (p=0.001). In contrast, WBC count and IL-6 and CRP concentrations were increased in the cats with bronchopneumonia, gastrointestinal tract infections and urinary tract infections compared to the healthy control and viral infection groups (p=0.001, p=0.001 and p=0.001, respectively). This study revealed significant differences between bacterial and viral infections regarding the fashion of inflammatory responses in cats, and the relevant data will undoubtedly contribute to the management and control of feline infectious diseases, rendering the development of novel therapeutic strategies.

Kiss1 receptor knockout exacerbates airway hyperresponsiveness and remodeling in a mouse model of allergic asthma

BackgroundIn asthma, sex-steroids signaling is recognized as a critical regulator of disease pathophysiology. However, the paradoxical role of sex-steroids, especially estrogen, suggests that an upstream mechanism or even independent of estrogen plays an important role in regulating asthma pathophysiology. In this context, in our previous studies, we explored kisspeptin (Kp) and its receptor Kiss1R’s signaling in regulating human airway smooth muscle cell remodeling in vitro and airway hyperresponsiveness (AHR) in vivo in a mouse (wild-type, WT) model of asthma. In this study, we evaluated the effect of endogenous Kp in regulating AHR and remodeling using Kiss1R knockout (Kiss1R−/−) mice.MethodsC57BL/6J WT (Kiss1R+/+) and Kiss1R−/− mice, both male and female, were intranasally challenged with mixed-allergen (MA) and/or phosphate-buffered saline (PBS). We used flexiVent analysis to assess airway resistance (Rrs), elastance (Ers), and compliance (Crs). Following this, broncho-alveolar lavage (BAL) was performed for differential leukocyte count (DLC) and cytokine analysis. Histology staining was performed using hematoxylin and eosin (H&E) for morphological analysis and Masson’s Trichrome (MT) for collagen deposition. Additionally, lung sections were processed for immunofluorescence (IF) of Ki-67, α-smooth muscle actin (α-SMA), and tenascin-c.ResultsInterestingly, the loss of Kiss1R exacerbated lung function and airway contractility in mice challenged with MA, with more profound effects in Kiss1R−/− female mice. MA-challenged Kiss1R−/− mice showed a significant increase in immune cell infiltration and proinflammatory cytokine levels. Importantly, the loss of Kiss1R aggravated Th2/Th17 biased cytokines in MA-challenged mice. Furthermore, histology of lung sections from Kiss1R−/− mice showed increased collagen deposition on airway walls and mucin production in airway cells compared to Kiss1R+/+ mice. In addition, immunofluorescence analysis showed loss of Kiss1R significantly aggravated airway remodeling and subsequently AHR.ConclusionsThese findings demonstrate the importance of inherent Kiss1R signaling in regulating airway inflammation, AHR, and remodeling in the pathophysiology of asthma.

HUMAN IMMUNODEFICIENCY VIRUS’ EXPOSED UNINFECTED NEWBORNS: A VULNERABLE POPULATION WITH SOME DEFECTIVE IMMUNE SYSTEM ELEMENTS AT BIRTH IN YAOUNDE-CAMEROON, CENTRAL AFRICA

Abstract Introduction/Objective The reduction in vertical transmission of human immunodeficiency virus (HIV) in Cameroon, thanks to the success of Option B+ prevention measures, has favored the increase in the rate of HIV exposed uninfected (HEU) infants. The latter, however, present a threefold higher morbidity and mortality than their HIV unexposed and uninfected (HUU) counterparts. With multiple causes, a dysfunction of the immune system would be incriminated but the evidence to demonstrate this and to advocate for a specific follow-up is lacking. This study objective was to determine the effect of in utero exposure to HIV-1 on certain immune elements of HEU newborns. Methods/Case Report A Case-control study was carried out in three reference hospitals in Yaounde. From June 2022 to July 2023, demographical characteristics of 62 HEU newborns of positive parturients with undetectable viral load who gave their consent (cases), and 65 HUU (controls) were taken. Then samples of umbilical cord blood were collected under ethical authorization no. BTC-JIRB2022-021. Then, blood count and differential leukocytes count were performed using DF55 DEMIND and May-Grünwald Giemsa Kit. Excel 2007 and R v4.1.3 softwares were used to record and analyze the data, with significance level for a p-value &amp;lt; 0.05. Results (if a Case Study enter NA) The average APGAR vitality score (appearance, pulse, grimace, activity, respiration) at 1, 5 and 10 min of life was reduced, but not significantly (p = 0.3) in the HEU (8/10, 9/10 and 10/10), compared to the HUU (9/10, and 10/10); as well as head circumference: (33.16 ± 1.64) cm and (34.8 ± 1.52) cm (p = 0.8) respectively. Unlike leukopenia (p=0.24), umbilical monocytosis (p=0.04) and lymphopenia (p=0.001) were significantly linked to HIV exposure in HEU, signs of inflammation from birth. Conclusion HIV exposed uninfected newborns present a drop in immunity and an inflammatory sign at birth, materialised clinically and biologically with a highly significant lymphopenia.

Preoperative Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Postoperative Infectious Complications in Pediatric Patients With Acute Appendicitis.

Background Several studies have investigated the role of neutrophil-to-lymphocyte ratio (NLR) in diagnosing and predicting the severity of acute appendicitis; however, few studies have analyzed its usefulness in pediatric appendicitis patients particularly in predicting postoperative complications. We investigated the role of NLR and assessed its clinical utility as a predictor of postoperative infectious complications in children with acute appendicitis. Methodology We performed a prospective cross-sectional study from July 2023 to July 2024 on 135 pediatric patients aged five to 12 years undergoing emergency appendectomy and having operative findings or histopathological confirmation of appendicitis. NLR was calculated from differential leucocyte count at the time of presentation to the emergency department. Patients were followed for one month after surgery for the development of complications. Univariate and multiple logistic regression was used to identify clinical factors significantly associated with postoperative complications. The sensitivity and specificity of these parameters to predict complications were determined using receiver operating characteristic curves. Results The average age was 8.36 ± 2.38 years. There were 36 (26.67%) laparoscopic and 99 (73.33%) open appendectomies. Eighty-three (61.48%) patients had simple while 52 (38.52%) had complicated appendicitis. NLR, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) were significantly higher in patients with complicated appendicitis (p< 0.05). Twenty-nine patients (21.48%) developed complications like wound infection (n = 29, 21.48%), wound dehiscence (n = 5, 3.7%), prolonged ileus (n = 12, 8.89%), intra-abdominal abscess (n = 7, 5.19%), and early adhesive obstruction (n = 4, 2.96%). Univariate and multiple logistic regression analysis of the clinical parameters revealed that NLR (OR: 1.28; 95% CI: 1.004-1.64), PLR (OR: 1.01, 95% CI: 1.001-1.01), and type of appendicitis (OR: 7.11; 95% CI: 1.57-32.22) had an independent significant association with all postoperative complications (p< 0.05). NLR and PLR presented an area under the curve (AUC) of 0.86(p < 0.001)and 0.83 (p < 0.001), respectively, which was significantly higher than the AUC of neutrophil count (AUC: 0.66, p = 0.006), lymphocyte count (AUC: 0.80, p < 0.001), CRP (AUC: 0.70, p = 0.001), and plasma sodium levels (AUC: 0.64, p = 0.006). NLR and PLR showed the highest sensitivity (79.3% and 79.3%) and specificity (95%and 82.1%) at cut-off values of 9.53 and 166.01, respectively. Conclusion The NLR can be used for distinguishing complicated from uncomplicated appendicitis, for prioritizing cases for operative management, and for identifying patients likely to experience complications after surgery.

B-314 Utility of he4 in differential diagnosis of pleural effusions

Abstract Background The usefulness of tumor markers in the differential diagnosis of cancer in patients with pleural effusions (PE) remains controversial. Few studies have reported the measurement of human epididymal protein 4 (HE4) in pleural fluid. HE4 is a tumor marker associated with different types of cancer. An elevated serum concentration has been observed in ovarian and lung cancers. Other benign pathologies can increase HE4 levels, which can be detect with different laboratory tests identified with adenosine deaminase (ADA), C-reactive protein (CRP), % polynuclear cell count (%PMN) and glomerular filtration rate (GFR) can be used in order to detect possible false positives. The objective of this study was to assess the diagnostic usefulness of HE4 in malignant pleural effusions by comparing HE4 concentrations between benign and malignant samples, while considering the causes of HE4 false positives. Methods HE4, ADA, differential leukocyte count, CRP and GFR concentrations were determined in 238 pleural effusion samples. Diagnostic efficacy analysis using receiver operating curves (ROC) identified the ability of HE4 to detect malignancy, searching for cut-off points with 100% specificity. Results HE4 concentrations showed significant differences (P&amp;lt;0.01) between malignant (median 1065pmol/L) and benign (median 699pmol/L) pleural effusions. Significant differences (P&amp;lt;0.01) were found in HE4 concentrations for gynecological and lung cancer origin (median 7397 pmol/L and 5150 pmol/L respectively) and other malignant pleural effusions (median 1065 pmol/L). Patients with benign diseases with renal failure showed a higher HE4 concentration (median 964pmol/L) than in patients without these pathologies (median 696pmol/L) identified with GFR&amp;lt;30 mL/min. No differences were demonstrated in HE4 concentration levels using ADA, differential leukocyte count or CRP, so only glomerular filtration rate was considered cause of false positives. A sensitivity of 23% was obtained for HE4, with a cut-off point of 3050pmol/L and a specificity of 100% for the whole group. In the potential false positive group, the sensitivity of HE4 was 28% with a cutoff point of 3050 pmol/L with a specificity of 100%. In the group without potential false positives, we obtained a sensitivity of 30% with a specificity of 100% for a cutoff point of 1992pmol/L. When we used a specific cut-off point for each group, we obtained a sensitivity of 38% with a specificity of 100%. Conclusions HE4 levels are higher in malignant pleural effusions compared to other pathologies. HE4 levels allow the identification of malignant pleural effusions with moderate sensitivity and maximum specificity. HE4 levels can differentiate between tumors of gynecological or lung origin and others. Glomerular filtration rate (GFR&amp;lt;30 mL/min) was considered the main cause of false positives. If we identify possible false positives, we can use specific cut-offs and improve sensitivity up to 38% with maximum specificity compared to using a single cut-off for all effusions.

Low leucocyte, neutrophil and lymphocyte count (tri-low phenotype) in melioidosis: A predictor of early mortality

IntroductionMelioidosis is a bacterial disease caused by Burkholderia pseudomallei, a gram-negative bacillus endemic to parts of Asia and Northern Australia. This study aimed to identify the role of total and differential leucocyte count in predicting 48-h mortality in patients with melioidosis. MethodologyThis retrospective cohort study included patients diagnosed with culture-proven melioidosis at Kasturba Medical College between 2017 and 2023. Total leucocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocytic count (ALC) were classified into low (first quartile), medium (second and third quartile) and high (last quartile). The chi-square test was used to compare each group's early (48-h) mortality. ResultsOf the 170 patients with culture-confirmed melioidosis, 24 patients died within 48 h. The mortality was significantly higher in those with low TLC, ANC and ALC. When all three parameters were found to be low (tri-low phenotype), the specificity in predicting mortality was 93.2 %. ConclusionLow TLC, ANC and ALC are significant predictors of mortality among melioidosis patients. There is a need to explore new strategies to improve clinical outcomes among melioidosis patients with tri-low phenotype.

White blood cell Indices to predict first trimester missed miscarriage.

To identify the relationship between white blood cell indices in missed miscarriage compared to ongoing pregnancy in the first trimester. The diagnostic accuracy study was conducted at the Department of Maternity, Al-Yarmouk Hospital, Baghdad, Iraq, from January to October 2021,and comprised healthy first-trimester pregnant women in group A and those with missed miscarriage after 7-13 weeks of gestation in group B. Ultrasound findings and the last menstrual period were noted for all the subjects. Total and differential leukocyte counts, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio were compared between the groups. Data was analysed using SPSS 22. Of the 167 women, 81(48.5%) were in group A and 86(51.5%) were in group B. Demographic and obstetrics data was not significantly different between the groups (p>0.05). Mean white blood cell, neutrophil and monocyte counts showed no significant difference between the groups (p>0.05), while lymphocyte count, neutrophil-tolymphocyte ratio and monocyte-to-lymphocyte ratio were significantly different between the groups (p<0.05). With respect to gestational age, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio had a fair ability to predict missed miscarriage at various time points within the first trimester (p<0.05). There was no significant correlation between WBC count and gestational age. Reduced MLR and NLR levels can be utilised to forecast miscarriages in a cost-effective manner.

Quantitatively characterize the response of the hybrid grouper (Epinephelus fuscoguttatus ♀ × Epinephelus lanceolatus ♂) under elevated temperature stress

Global warming may affect the health of marine species. However, the collected information on quantitative assessment of response in fish under elevated temperature is poorly defined. The present study aimed to quantitatively evaluate the effects of the hybrid grouper (Epinephelus fuscoguttatus ♀ × Epinephelus lanceolatus ♂) under elevated temperature (33 °C and 36 °C, ET1 and ET2) stress for 14 days. As endpoints, we examined changes in body growth, hemato-immunological parameters, liver oxidative stress markers, as well as changes of the stomach digestive enzymes. Compared to the control, the body weight was significantly decreased in ET2 group for 14 d exposure, and a remarkable change of differential leukocyte counts of the fish was observed in ET1 group at 3 d and in ET2 group at 14 d. The respiratory burst activity of the hybrid grouper leukocytes markedly decreased in the treatment groups after 14-d exposure. Overall, the antioxidant enzyme activities and transcriptional levels of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), and glutathione peroxidase (GSH-PX) were markedly inhibited in the liver for 3-d and 14-d exposure. The expression levels of nf-κb mRNA were significantly inhibited while the expression levels of atp2b1 mRNA were significantly induced after 14-d exposure. The activities of pepsin and lipase in the stomach were significantly reduced. In addition, an innovative hazard classification system (ET-HCS) was developed to quantitatively characterize the stress response of the fish following elevated temperature treatments. The stress level of ET2 group for 14-d exposure was ranked as level IV (high stress), and the other treatments were ranked as level II (low stress). Taken together, the findings of this study further extend our understanding of quantitative assessment of response in fish under high-temperature stress, which provides valuable information for improving countermeasures of mariculture industry.

Association between full blood count and urine steroid metabolome in patients with adrenal masses

Background: Endogenous hypercortisolism of adrenal origin is commonly associated with immune suppression. However, these patients also have signs characteristic of chronic inflammatory diseases. Better understanding of the mechanisms that alter the functioning of the immune system would allow for the development of a patient-centered approach to the treatment of corticotropin-independent endogenous Cushing's syndrome (CS). Aim: To assess the association between full blood count and gas chromatography-mass spectrometry-based urinary steroid excretion in patients with adrenal masses depending on malignancy grade and presence of hypercortisolism. Materials and methods: We retrospectively analyzed data from 42 patients with adrenal masses who had not received chemotherapy. The median age of the patients was 54 [Q25; Q75: 37; 63] years, and 76% of them were female. Preoperatively, all patients had hematology tests with differential leukocyte count. Steroid metabolome was assessed with Shimadzu GCMS-TQ8050 gas chromatography-mass spectrometer. Results: Twelve (12) patients had adrenocortical cancer (ACC) and CS, 9 patients had ACC without CS, 11 had adrenocortical adenomas (ACA) and CS, and 10 patients had ACA without CS. ACC patients had a higher neutrophil-to-lymphocyte ratio (NLR) than those with ACA: 3.35 [2.5; 6.3] vs 1.99 [1.41; 2.65] (р = 0.001). There was a linear correlation between NLR and serum cortisol levels after the 1 mg overnight dexamethasone suppression test (r = 0.41, p = 0.01), urinary excretion of 5β-tetrahydrocortisol (5β-THF) (r = 0.71, p 0.001) and 11β-hydroxyandrosterone (11β-OH-An) (r = 0.74, p 0.001). The ACC patients without CS had lower 5β-THF urinary excretion values, compared to ACA with CS patients: 931 [616; 1610] and 3139 [1480; 4375] mcg/24h, respectively (р = 0.007). 11β-OH-An urinary excretion in ACC patients without CS was higher than in ACA patients with CS: 1170 [806; 1266] и 602 [320; 739] mcg/24h (р = 0.007). The NLR cut-off value for adrenal mass malignancy in patients with CS exceeded 2.72 (sensitivity 90.0%, specificity 80.0%), and for the patients without hypercortisolism was above 1.92 (sensitivity 71.4%, specificity 100.0%). Conclusion: This is the first association identification between NLR, which is the marker of systemic inflammation, inflammation, and urinary excretion of 11β-OH-An, a metabolite of 11-hydroxyandrostenedione (a member of 11-oxygenated androgen family). This extends our understanding of the impact of hormonal activity of adrenal mass cells on the immune system.

Investigation of Hepatozoon Canis Related Alterations in the Haemato Biochemical Profile of Dogs

Aims: Hepatozoonosis, caused by a protozoan parasite Hepatozoon canis, is important for canine health due to its ability to cause chronic, debilitating disease, and the challenges it presents in terms of diagnosis and management. The present study was conducted to see the effect of H. canis infection on various haematological and biochemical parameters as compared to the normal healthy dogs in order to understand the disease pattern and suspecting the disease. Study Design: The clinically affected dogs that come to the veterinary hospital with symptoms of hepatozoonosis were included in the study. Haematological and biochemical parameters of dogs found positive for hepatozoonosis were analysed. The values of these parameters were subsequently compared to healthy animals in order to identify any significant difference caused by H. canis. Place and Duration of Study: The studied was conducted at Department of Veterinary Medicine, DUVASU Mathura, India. Total 212 blood samples were collected from the dogs that were brought for the treatment in between February 2023 to March 2024. Methodology: Total 212 dogs were included in the present study out of this 46 dogs were found positive with H. canis using PCR based molecular test. These positive animals were subjected to study the changes in biochemical parameters like blood urea nitrogen, creatinine, alkaline phosphatase, alanine transaminase, aspartate amino transferase, total leucocyte count, total erythrocyte count, haemoglobin, haematocrit, erythrocyte indices (MCV, MCH, MCHC), differential leucocyte count, platelet count and platelet indices (MPV, PDW) using autoanalyzer. Student's t-test in Graphpad Prism was used to compare these values to healthy animals. Results: The study confirms that Hepatozoonosis leads to significant haematological and biochemical changes in dogs. Infected dogs have lower Hb, TEC, and PCV than healthy animals, indicating anaemia. Thrombocytopenia and leukocytosis were also observed in the infected animals. Non-significant differences in MCV, MCH, and MCHC indicate normocytic, normochromic anaemia. Anisocytosis and non-regenerative anaemia is indicated by significant RDW-CV increases with decrease in MCV values. Increased liver-specific enzymes like ALT, AST, and ALP and kidney-related enzymes like BUN and CRT suggest hepatic and renal involvement in disease pathophysiology. Conclusion: In hepatozoonosis, haemato- biochemical parameters like non-regenerative anaemia. anisocytosis, thrombocytopenia, leukocytosis, low serum protein concentration and increased ALT, AST, ALP and BUN values may be used as non-specific biomarkers. The results can be used in making clinical decisions and monitoring therapeutic responses in cases of hepatozoonosis.

A comprehensive investigation into the ranges of laboratory tests present in cerebrospinal fluid across various types of meningitis within different age categories

Background. Diagnosing meningitis requires a lumbar puncture to analyze cerebrospinal fluid (CSF) and determine the causative pathogen. Key diagnostic measures include Glucose and Protein concentrations, cell count, differential leukocyte count, Gram stain, culture, and PCR if necessary. Objective. Our analysis assessed patterns in key biomarkers—neutrophils, lymphocytes, cerebrospinal fluid white blood cell count, and CSF/blood Glucose and Protein ratios—across various types of meningitis, including meningococcemia, meningococcal, tuberculous, pneumococcal, aseptic, and other bacterial meningitis. We examined these biomarkers within distinct age categories: children (0-12 years), adults (13-64 years), and the elderly (≥ 65 years). Methods. Descriptive statistics were used to analyze various types of meningitis across different age groups. We assessed the normality of laboratory biomarkers using the Shapiro-Wilk test, and applied Welch ANOVA to explore potential differences in biomarker levels among various types of meningitis. A Games-Howell post hoc test was used to identify specific pairs of meningitis types with statistically significant differences in biomarker levels. Results. The analysis of variance of cerebrospinal fluid biomarkers revealed significant differences in CSF WCC (cells/mm3), Neutrophils (%), Lymphocytes (%), CSF/blood Glucose and Protein ratios in children and adults (p &lt;0.05). However, differences were observed solely in neutrophil levels among elderly subjects. In bacterial meningitis, neutrophil levels increased across all ages, with adults showing higher levels. For meningococcal meningitis, adults had a median neutrophil level of 78.5% [60%, 90%] compared to 57% [24.5%, 85.25%] in children. The CSF white cell count (WCC) median was also higher in adults (339 cells/mm³) compared to children (224 cells/mm³). Viral meningitis cases exhibited higher lymphocyte levels across all age groups, with medians of 69% [34%, 87%] in children, 82% [61%, 93%] in adults, and 77% [55%, 90%] in the elderly. The glucose ratio was lower in bacterial meningitis (&lt;0.3) and higher in viral cases (&gt;0.5). Protein ratios were elevated in bacterial meningitis, indicating increased blood-brain barrier permeability. These results demonstrate a distinct biological profile for different causative agents, modulated by patient age.

Prediction of Postoperative Recurrence of Chronic Subdural Hematoma Using Preoperative Systemic Immune Inflammation Index and Eosinophils.

Objective Chronic subdural hematoma (CSDH) is a common neurological problem with significant recurrence after surgery. Risk considerations can vary, ranging from patient-related factors to those related to the surgical procedure. This study explores the association between preoperative eosinophil count and systemic immune inflammation (SII) with CSDH recurrence. Materials and Methods We conducted a prospective analysis of 105 patients with equal numbers of CSDHs who underwent surgery for CSDH between January 2023 and January 2024. The preoperative eosinophil counts, along with other differential leukocyte counts, were measured. The SII index was calculated using the standard formula (SII = neutrophil count × platelet count/lymphocyte count). Multivariate and univariate regression analyses were performed to assess the association between risk factors and CSDH recurrence. Results The preoperative eosinophil count showed a significant correlation with recurrence ( p < 0.001). The SII index was significantly higher in patients with recurrent CSDH ( p = 0.003). Neutrophils were found to be significantly associated with CSDH recurrence ( p = 0.038). Age ( p < 0.001) and SII ( p = 0.005) were found to be independent predictors of CSDH recurrence, whereas hematoma volume ( p < 0.001) and the antiplatelet regimen were a significant predictor of CSDH recurrence ( p = 0.047). Variables like male gender, diabetes mellitus, anticoagulants, and hematoma volume were associated with eosinophil-rich or eosinophil-poor status. Conclusion Preoperative eosinophil count, neutrophils, and the SII index may serve as potential predictors of CSDH recurrence. Further studies with larger sample sizes are needed to validate these findings.

Morphology and differential counts of blood cells as important health indicators in the olm, Proteus anguinus

Abstract Haematological investigation is an important component of stress and immune response assessment and holds great potential for evaluating amphibian welfare. The olm (Proteus anguinus) is a neotenic, cave-dwelling salamander endemic to the Dinaric Karst and classified as a vulnerable species by the IUCN. The aim of the present study was to gain basic knowledge about the haematology of this endangered species and to establish reference values of leucocyte differential counts. Blood smears were obtained from recently captured animals and compared to smears from the same animals in long-term captivity (up to five years). The elongated erythrocytes are nucleated and are among the largest in vertebrates, which is also reflected in their lower concentration per millilitre of blood. The circulating blood can contain mitotically active, immature erythrocytes (erythroblasts), indicating that erythrocytes of the olm can undergo proliferation and maturation in circulating blood. Olms show a typical urodele leucocyte profile, with lymphocytes predominating, followed by neutrophils, although the proportion of lymphocytes is higher than in other urodeles. Eosinophil and monocyte counts were relatively low, while basophils were nearly absent. We found no statistically significant differences in leucocyte counts or in neutrophil to lymphocyte ratio neither between recently captured olms and same animals during captivity nor between the sexes, except for lower neutrophil count in captive females. Thus, no differences in stress levels between recently captured olms and captive olms were detected via haematological investigations. The significance of these results is discussed in the context of detecting stress and immune responses in olms.

Significance of leukocyte and platelet counts in hypertensive disorders of pregnancy - A retrospective study in a tertiary care hospital

: Hypertensive disorders in pregnancy are a spectrum of disorders ranging from gestational hypertension, pre-eclampsia to eclampsia and chronic hypertension superimposed by pre-eclampsia. With an incidence of 7-15% complicating pregnancies, several theories have been stated to define the pathogenesis. Inflammation per se is also found to have its part in the pathogenesis of hypertension.: To evaluate and compare the inflammatory mediators namely the leukocyte count, platelet count, absolute neutrophil count, absolute lymphocyte count, neutrophil lymphocyte ratio and platelet lymphocyte ratio among the hypertensive disorders in pregnancy.: This is a retrospective study done at a tertiary care hospital including all women admitted with hypertension in pregnancy from 26th April 2016 to 31 March 2019. Patients with singleton pregnancy with hypertension were included and those with prelabour rupture of membranes or concomitant infection were excluded. Patients were divided into four groups, chronic hypertension, and gestational hypertension, non-severe and severe preeclampsia. The total and differential leukocyte counts at admission were accessed from the medical records and statistical analysis was done.: Out of 4860 deliveries, 294 patients were diagnosed with hypertensive disorders (6.04%). Of the 294, those belonging to chronic hypertension, gestational hypertension, non-severe and severe preeclampsia were 43 (14.6%), 128(43.5%), 52(17.7%) and 71(24.1%) respectively. A p value of &amp;#60; 0.05 was considered significant. It was found that there was a significant difference among the groups in mean age and chronic hypertension was found to have a higher mean age than the other groups. The mean platelet count was also found to be significantly higher in chronic hypertension as compared to other groups. There was no significant difference in both mean total and mean differential leukocyte counts, ANC, ALC, NLR and PLR among the four groups.

Temporal Dynamics of Plasma Catecholamines, Metabolic and Immune Markers, and the Corticosterone:DHEA Ratio in Farmed Crocodiles before and after an Acute Stressor.

Commercial crocodilian farms face significant economic and livestock losses attributed to stress, which may be linked to their adopted husbandry practices. The development of appropriate and modernized husbandry guidelines, particularly those focused on stress mitigation, is impeded by the limited understanding of the crocodilian stress response. Fifteen grower Nile crocodiles were subjected to simulated acute transport stress, with blood samples collected at various intervals post-stress. Plasma levels of corticosterone (CORT), dehydroepiandrosterone (DHEA), adrenaline, and noradrenaline were determined using high-performance liquid chromatography. Glucose and lactate were measured using portable meters and the heterophil-to-lymphocyte ratio (HLR) was determined via differential leucocyte counts. Significant differences were elicited after the stressor, with acute fluctuations observed in the fast-acting catecholamines (adrenaline and noradrenaline) when compared to the baseline. Downstream effects of these catecholamines and CORT appear to be associated with a persistent increase in plasma glucose and HLR. Lactate also showed acute fluctuations over time but returned to the baseline by the final measurement. DHEA, which is used in a ratio with CORT, showed fluctuations over time with an inverted release pattern to the catecholamines. The study highlights the temporal dynamics of physiological markers under acute stress, contributing to our understanding of crocodilian stress and potentially informing improved farming practices for conservation and sustainable management.