Differential WBC Counts Research Articles

2759 Eosinophilic Gastritis Responding to Proton Pump Inhibitor

INTRODUCTION: Eosinophilic gastritis is a rare condition that is part of a spectrum of gastrointestinal eosinophilic infiltration disorders which also includes eosinophilic esophagitis, enteritis, and colitis. They are characterized by excess eosinophils in the mucosal biopsy of one or more sites of the gastrointestinal tract in the absence of any specific causes of eosinophilia. Patients may present with symptoms including nausea, vomiting, abdominal pain, and weight loss. First-line of treatment is steroids. We describe a case of eosinophilic gastritis that was successfully treated with Proton pump inhibitor therapy. CASE DESCRIPTION/METHODS: A 23-year-old male presented to the outpatient clinic with a six-month history of episodic epigastric discomfort and retrosternal burning pain. Each episode lasted several hours and was precipitated by food intake. He had previously taken omeprazole 10 mg on and off for 4 weeks without any response. He had no history of any allergic disease. H.pylori stool antigen was negative. He was subsequently treated with four-week therapy of tricyclic anti-depressants with no response. Following this, he underwent upper gastrointestinal (UGI) endoscopy which showed mild erythema in the antrum. Gastric biopsy showed extensive eosinophilic infiltration with >50 cells/HPF in >5 HPF with normal esophageal and duodenal biopsy. Differential WBC count showed mild eosinophilia (7%). In line with a diagnosis of eosinophilic gastritis the patient was advised six food elimination which he refused. He was then started on Pantoprazole 40 mg once daily which was increased to twice daily after a week due to continued reflux symptoms. His symptoms gradually resolved over the next 12 weeks. On follow-up visit 3 months later he underwent repeat UGI endoscopy with biopsy which showed complete resolution of eosinophilic gastritis. The patient continues to remain asymptomatic. DISCUSSION: Eosinophilic gastrointestinal disorders can involve any part of the gastrointestinal tract from the esophagus to the colon. The antrum of the stomach is most commonly involved. There are no recognized guidelines for the treatment of eosinophilic gastritis, although steroid therapy is the mainstay of treatment. The role of PPI in the treatment of eosinophilic esophagitis is well known, but the utility of the same in eosinophilic gastritis has not been well defined. Our patient had symptomatic gastritis with biopsy revealing extensive eosinophilic infiltration. He responded excellently to 12-week pantoprazole therapy.

The immunological and protective role of Baicalin in male rats treated with chemotherapy (Gemcitabine)

Background Baicalin the chemical compound also known as Flavonoid glycoside derived from a Chinese herbal plant (Scutellaria baicalensis) that possesses various biological properties. Baicalin has been an important medical agent with a variety of pharmacological properties. Aims of study: The current study aimed to evaluate the immunological and protective role of the herbal extract (Baicalin) in male rats treated with chemotherapy (Gemcitabine), by measuring the level of some cytokines (IL-10 & IL-12), and measuring the level of antioxidants (MDA & GSH) in the serum of rats by the ELISA technique. The study also included measuring the level of phagocytosis index and the WBC differential count. Materials and Methods: This study was conducted in the animal husbandry of the college of Veterinary Medicine / Al-Qadisiyah University from January, 2018 to June, 2018. Eighty (80) male Albino Rats (Rattus norvegicus) were used in the experiment, and were divided into eight groups, each group had 10 animals. Results: As per the statistical analysis results it was observed that there is significant difference in the study group at the level (P <0.05). The data obtained showed a significant decrease (IL-10 & IL-12) in the T5 group treated with Baicalin in combination with chemotherapy (Gemcitabine) compared to the T1 and T2 groups treated with chemotherapy drug. Not only this, the result obtained showed the marked decrease in the study groups T1 and T2 treated with chemotherapy (Gemcitabine) compared to T3, T4, and T5 groups treated with herbal extract (Baicalin) and control group. While the antioxidant results also showed the marked increase (MDA) in group T1 and T2 treatment with Gemcitabine compared to the study groups. As well as significant decrease in (GSH) in T1 and T2 groups treated with Gemcitabine compare to T3, T4, T5, T6 and control. And the results of the statistical analysis showed a significant decrease in both lymphocytes, neutrophils, and monocytes in the T1 and T2 groups compared to all study groups. Conclusion: Baicalin has a significant preventive role in reducing oxidative stress induced by chemotherapy drugs and has a significant role in improving immune and defensive lines of the body against pathogens.

Alpha-linolenic acid ameliorates bronchial asthma features in ovalbumin-sensitized rats.

Effect of alpha-linolenic acid (ALA) against ovalbumin (OVA)-induced inflammation, oxidant/antioxidant imbalance and pathological features was examined in rat. Total and differential WBC count and oxidant/antioxidant levels in BALF (bronchoalveolar lavage fluid) as well as lung pathological features were investigated in five groups of rats including controls (group C), rats sensitized with OVA (group S) and S treated with either ALA (0.2 and 0.4mg/ml) or dexamethasone. As compared to group C, in OVA-sensitized rats, increases in WBC counts, levels of oxidant biomarkers and most pathological scores were observed while lymphocyte percentage and antioxidants levels decreased. Treatment with ALA (0.2 and 0.4mg/ml) significantly reduced total WBC, NO2 and NO3 levels, interstitial fibrosis and emphysema compared to sensitized group. The higher dose of ALA also significantly decreased neutrophil, eosinophil, and monocyte counts, MDA levels and interstitial inflammation but increased lymphocyte counts, as well as antioxidants levels, compared to sensitized group. Dexamethasone administration led to a significant improvement of most factors compared to group S but had no effects on total WBC count, bleeding and epithelial damage. Alpha-linolenic acid suppressed inflammation and oxidative stress, making it a potential therapeutic candidate for treatment of airway inflammatory diseases such as bronchial asthma.

Effect of microalgae Spirulina spp. as food additive on some biological and blood parameters of common carp Cyprinus carpio L.

This study was carried out to study the effect of adding different levels of the microalgae Spirulina spp. in fish laboratory of Animal Sciences Department, College of Agricultural Sciences of Sulaimani University, Sulaimani, Iraq. A total of 72 common carp fingerling weight 45±2 gm used to detect the effect of three different levels of the algae Spirulina spp. The control treatment T1 with 0%., T2 with 3 gm /kg diet and T3 with 5 gm Spirulina /kg diet. Each treatment in three replicates in which six fingerlings common carp were stocked in each aquarium. Results indicated no significant differences at PSpirulina) in T3 was higher significantly at PSpirulina was higher significantly at PSpirulina to common carp diets in different levels leads to significant differences in differential WBC counts, T3 with 5 gm Spirulina /kg diet was higher in WBC counts. Lymphocytes were higher in each of control and T3. Monocytes were higher in control, granulocytes in T2 with 3 gm Spirulina /kg diet. Adding of Spirulina affected significantly in cholesterol as compared to the control. Triglyceride was higher in control and T2. T3 with 5 gm Spirulina /kg diet leads to higher and lower significantly in HDL and LDL respectively. T1 and T3 were higher significantly in spleenosomatic index. Inclusion of S. platensis in fish diet as a feed additive or as a partial replacer of the expensive fishmeal imposes significant promotions in fish growth, coloration, reproduction and flesh quality.

Investigation of the cellular and soluble markers of inflammation for the assessment of cardiovascular risk in patients with acute coronary syndrome in Bangladesh

Acute coronary syndrome (ACS), one of the leading causes of mortality in Bangladesh, occurs when a plaque in the coronary artery suddenly ruptures and obstructs the flow of blood to the heart causing myocardial tissue necrosis. In this study, a total of 140 participants were enrolled including 70 ACS patients and 70 non-ACS controls. The total and differential WBC counts, myeloperoxidase (MPO) activity, ischemia-modified albumin (IMA), interleukin-6 (IL-6) and complement functions were investigated and the values were compared between the study groups. We found the total WBC count, neutrophil to lymphocyte ratio (NLR), plasma MPO activity, serum IMA, and IL-6 levels were significantly higher in the ACS patients while the complement-mediated bactericidal activity was significantly lower. The results on NLR, MPO activity, and IL-6 levels demonstrate activation of cellular and soluble inflammatory mediators in ACS, which may be potential diagnostic biomarkers.

Hematological parameters and aminotransferase changes in dengue infection

Background: Dengue is a viral disease that is caused by dengue virus. The incidence of dengue has rapidly increased over the last few years. Classical dengue fever presents as fever, generalized body ache, myalgia, arthralgia, and headache. The hematological parameters such as hemoglobin (Hb), hematocrit (Hct), WBC count, differential WBC counts and platelet count vary each day of the fever in dengue patients. This study was undertaken to study the various hematological parameters and aminotransferases and their correlation with severity of dengue.Methods: Descriptive study of 100 patients admitted in KBNTGH, Kalaburagi was carried out to evaluate the hematological parameters and changes in aminotransferase levels.Results: 58 were male and 42 were female and the age ranged between 1yr-75yr. The haemoglobin was found to be decreased in 28% of the cases, whereas in 19% of the cases hematocrit was found to be increased. 52% of the cases had a decreased leucocyte count and 66% showed increased lymphocyte percentage. Decrease in platelet count was seen in 87 cases. 85 showed increased AST levels and 67 showed increased ALT levels.Conclusion: Dengue is a self-limiting disease. Peripheral blood parameters are very helpful for disease monitoring and can be useful in prediction of prognosis. Liver involvement is also seen and is related to severity of dengue. These indicators, if rightly and timely assessed can be of value for better care of complicated cases

Clinical, Bacteriological and Radiological study of severe pneumonia in age group of 2 months to 5 years

Background: Acute respiratory infections (ARI) are one of the commonest causes of death in children in developing countries. The future health of children depends on preventing, diagnosing, treating and limiting Acute Lower Respiratory Tract Infection. The use of these clinical signs in the early detection and treatment of children with pneumonia by primary health care workers forms the basis for the case management strategy formulated by the World Health Organization (WHO) to control mortality and morbidity. Objectives: to study clinical, bacteriological and radiological features of severe pneumonia and to correlate clinical findings with radiological and bacteriological findings. Materials and Method: A prospective observational study among children between 2 months to 5 years of age. A detailed analysis of symptoms and signs such as fever, cough, rapid breathing, refusal of feeds, wheezing, respiratory rate, presence of fever and other signs of cyanosis, etc were noted. Investigations like Hemoglobin, Total WBC count, Differential WBC count, ESR, blood culture Chest X-ray and if require CT scan were done in all patients. Significance for the statistical tests was predetermined at a probability value of 0.05 or less. (p&lt;0.05) Results: over a period of one and half year total 150 cases were included in the study, nearly all patients were presented with cough, tachypnea, fever, chest retractions and other signs. Positive radiological finding were seen in 80.66% of cases.Among bacterial pneumonia, defined radiologicaly; 63.15% had elevated WBC counts; 88.42% had neutrophilia, 67.27% had elevated ESR. Case fatality rate was 6.3% (9 cases). Conclusion: clinical diagnosis by WHO ARI criteria are very sensitive and still can be applied to hospitalized children. Chest X-ray is valuable aid in the diagnosis of pneumonia in children

EFFECT OF DIFFERENT GESTATION PERIODS ON SOME PHYSIOLOGICAL ASPECTS OF IRAQI FEMALE DROMEDARY CAMEL (Camelus dromedarius)

This study was conducted to investigate the influence of different gestation periods on hematological and biochemical profile of Iraqi female camel. The study was done at the College of Veterinary Medicine, University of Fallujah during the period from August, 1 to July, 11, 2013. The experiment included 12 (6 pregnant and 6 non-pregnant), Iraqi female camels. Blood samples were collected at days 20, 30, 40, 50, 60, 90, 120, 150 and 180 post-mating (PM). The blood samples for hematological, biochemical and plasma minerals assay. ESR and eosinophils were showed no significant different (P≤0.05) during different gestation period. Excluding data for cholesterol, HDL and LDL, all other biochemical parameters in pregnant camels showed higher significant differences (P≤0.05). Calcium, phosphorous, sodium, potassium and magnesium were increased significantly different (P≤0.05) during various gestation period. Non-significant differences were observed between pregnant and non–pregnant females in WBC's, ESR, MCHC and differential leukocytes count, while P.C.V, Hb, RBC's, MCV and MCH exhibited higher significant different (P≤0.05) between different stages. The total protein, albumin, HDL and LDL higher significant different (P≤0.05), all other biochemical parameters between pregnant and non– pregnant were showed non- significant. Phosphorous was the unique mineral showed increased significant different (P≤0.05) between pregnant and non–pregnant female camels. In conclusion, different effects of gestation periods were noticed on some hematological, biochemical parameters as well as plasma minerals of Iraqi female camels.

Haematology of N'Dama and West African Shorthorn cattle herds under natural Trypanosoma vivax challenge in Ghana.

Background: Animal trypanosomosis is a major cause of economic loss in livestock production in Africa. A suggested control measure is to use breeds with traits of trypanotolerance. The study examines the effect of natural Trypanosoma vivax challenge on haematological parameters in two trypanotolerant cattle [N'Dama and West African Shorthorn (WASH)] herds. Methods:Trypanosoma vivax-specific primers were used to diagnose T. vivax infection in an N'Dama herd at Cape Coast in southern Ghana and a WASH herd at Chegbani in northern Ghana from May to July 2011 in a cross-sectional study. Levels of haematological parameters comprising packed cell volume (PCV), haemoglobin (Hb) concentration and red blood cell (RBC) and total white blood cell (TWBC) counts; differential WBC counts (neutrophils, lymphocytes, eosinophils, monocytes and basophils); and RBC indices of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were determined in blood samples and then compared between infected and uninfected cattle. Results: We found that haematological indices for infected and uninfected animals in both breeds were within the normal range. However, the mean PCV values for T. vivax-infected WASH and N'Dama were lower in infected compared to uninfected animals. The difference was significant ( p< 0.05) in N'Dama but not in WASH. Conclusion: Despite the presence of infection by T. vivax, N'Dama and WASH cattle maintained their haematological parameters within acceptable normal ranges, which confirms their trypanotolerant trait. This highlights the need for low-input traditional African farmers in medium, high and severe tsetse challenge areas to be educated on the advantages of N'Dama and WASH breeds to increase their utilization in integrated tsetse and trypanosomosis control programmes.

The haemato-protective effect of Piliostigma thonningii leaf extract on indomethacin-induced gastric mucosa ulcer in rats

Background: Gastric ulcer is a common gastrointestinal disorder with global consequence, which is aggravated by an imbalance between the aggressive factors and factors that maintain the mucosal integrity. The role of Piliostigma thonningii leaf extract on hematological indices of indomethacin-induced gastric mucosa lesions in Wistar rats was examined.Methods: Thirty-six male rats were divided into six groups of 6 rats each. Group I, the normal control, II gastric ulcerated + cimetidine (standard control), III extract only (100mg/kg bwt), while IV, gastric ulcerated control, V gastric ulcerated + extract (100mg/kg bwt) and VI gastric ulcerated + extract (200mg/kg bwt). After 12 days of administration, gastric ulcer was then induced by oral administration of 40mg/kg bwt indomethacin to rats in groups II, IV, V and VI. The rats were sacrificed 12 hours after indomethacin treatment and blood collected for hematological assay.Results: The RBC count and Hb pattern were similar. There was a significant (P&lt;0.05) decrease in RBC and Hb of the ulcer control group which was normalized on administration of 200mg/kg bwt of P. thonningii extract. The MCV of the ulcer lesion was significantly (P&lt;0.05) reversed to normal by the extract.Conclusions: The P. thonningii leaf extract showed promising result by normalizing decreased levels in RBC and Hb caused by ulcer. Except for platelet counts, the WBC count and differential WBC counts were quite positive. It was able to reverse macrocytosis caused by ulcer lesions to normal, hence exhibiting a hemato-protective nature.

Hemato-biochemcial characteristics of lambs on dietary feed additives (exogenous fibrolytic enzymes, Artemisia absinthium Linn.) supplementation

Dietary composition affects blood metabolic profile of farm animals. Hemato-biochemical indices serve as clinical indicators for the impact of dietary manipulations on physiological health status. To augment sheep productivity in temperate regions by improving animal health conditions, the present study was undertaken to assess the effect of supplementation of exogenous fibrolytic enzymes (EFE) cocktail and Artemisia absinthium L. (commonly known as wormwood) herb alone and in combination as feed additives on blood metabolic profile in lambs. Crossbred lambs (n = 20) divided into four equal groups of five in each and fed for 90 days followed by 6 days of metabolism trial on oat straw-based complete feeds supplemented with either EFE cocktail (T1) @ 6 g/kg DM or wormwood herb (T2) @ 4.5% of DM or a combination of the two (T3) and complete feed without any supplementation served as control (T0). Hemato-biochemical parameters of all the animals were studied at 0-, 30-, 60-, and 90-day intervals. The feed additives supplementation improved the nutritive value of diets; however, the significant (P < 0.01) effect for percent digestible crude protein and digestible energy were with T3 where combination of enzymes and herb was applied, whereas higher (P < 0.05) percent total digestible nutrients were recorded in groups supplemented with wormwood herb (T2 and T3) compared to control. Feed additive supplementations did not change significantly the mean observations of red blood cell (except hematocrit) and platelet indices, total blood cell counts, energy metabolic profile, serum total cholesterol and total triglycerides, serum total proteins, serum albumin, aspartate aminotransferase, serum creatinine, and uric acid levels; however, feed additive supplementation have a significant positive effect on differential WBC counts, high-density lipoproteins (P < 0.05), low-density lipoproteins, atherogenic index, serum globulin, and albumin: globulin ratio and serum urea nitrogen (P < 0.01) levels among the treatment groups. The hemato-biochemical metabolic profile of feed additive-supplemented lambs revealed better physiological health status compared to un-supplemented animals. Supplementations of EFE cocktail, wormwood herb, or their combination improved the nutritive value of diets without any adverse effects on hematological and blood biochemical parameter suggesting supplementation of the feed additives for successfully raising lambs intensively.

Haematology of N’Dama and West African Shorthorn cattle herds under natural Trypanosoma vivax challenge in Ghana

Background: Animal trypanosomosis is a major cause of economic loss in livestock production in Africa. A suggested control measure is to use breeds with traits of trypanotolerance. The study examines the effect of natural Trypanosoma vivax challenge on haematological parameters in two trypanotolerant cattle [N’Dama and West African Shorthorn (WASH)] herds. Methods: Trypanosoma vivax-specific primers were used to diagnose T. vivax infection in an N’Dama herd at Cape Coast in southern Ghana and a WASH herd at Chegbani in northern Ghana from May to July 2011 in a cross-sectional study. Levels of haematological parameters comprising packed cell volume (PCV), haemoglobin (Hb) concentration and red blood cell (RBC) and total white blood cell (TWBC) counts; differential WBC counts (neutrophils, lymphocytes, eosinophils, monocytes and basophils); and RBC indices of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were determined in blood samples and then compared between infected and uninfected cattle. Results: We found that haematological indices for infected and uninfected animals in both breeds were within the normal range. However, the mean PCV values for T. vivax-infected WASH and N’Dama were lower in infected compared to uninfected animals. The difference was significant ( p< 0.05) in N’Dama but not in WASH. Conclusion: Despite the presence of infection by T. vivax, N’Dama and WASH cattle maintained their haematological parameters within acceptable normal ranges, which confirms their trypanotolerant trait. This highlights the need for low-input traditional African farmers in medium, high and severe tsetse challenge areas to be educated on the advantages of N’Dama and WASH breeds to increase their utilization in integrated tsetse and trypanosomosis control programmes.

White blood cell subpopulation changes and prevalence of neutropenia among Arab diabetic patients attending Dasman Diabetes Institute in Kuwait.

BackgroundThe effects of diabetes mellitus on the differential white blood cell count are not widely studied in the Arab populations. The objective of this cross-sectional, retrospective study is to assess the influence of chronic diabetes mellitus on white blood cell counts, absolute neutrophil (ANC) and lymphocyte counts (ALC) as well as the prevalence of benign ethnic neutropenia among Arabs attending the Dasman Diabetes Institute (DDI) in Kuwait.Methods and findings1,580 out of 5,200 patients registered in the DDI database qualified for our study. Age, gender, HbA1c and creatinine levels, estimated glomerular filtration rate as well as average WBC, ANC and ALC levels, presence of diabetes-associated complications and anti-diabetic medications were analyzed. Our results showed the mean value of the WBC was 7.6 ± 1.93 x 109/L (95% CI: 2.95–17.15). The mean ANC was 4.3 x 109/L (95% CI: 0.97–10.40) and mean ALC was 2.5 x 109/L (95% CI: 0.29–10.80). Neutropenia (ANC: <1.5 x 109/L) was detected in fifteen patients (0.94%). Six patients (0.4%) fulfilled the definition of lymphopenia (ALC < 1 x109/L). Patients with an HbA1c ≥ 7% and those taking at least 3 anti-diabetic medications showed higher values for ANC and ALC. Patients with diabetes-associated neuropathy or nephropathy displayed higher mean ANC values. Our study was limited by overrepresentation of patients over 50 years old compared to those under 50 as well as selection bias given its retrospective nature.ConclusionsOur study showed that patients with poorly controlled diabetes displayed higher ANC and ALC levels. In addition, patients with DM-associated complications showed higher ANC levels. This finding would suggest that DM exerts a pro-inflammatory influence on differential WBC counts. Our study also showed that the prevalence of benign ethnic neutropenia was lower than previously reported in other studies.

Combined and breed‐specific RIs for hematologic, biochemical, and hormonal analytes in Chios and Florina adult rams

Clinical pathology investigations are essential to evaluate the health status and practice management of ruminants. Appropriate and accurate RIs are required for the interpretation of laboratory results. Despite substantial phenotypic differences and management-related disparities between male and female sheep, RIs in rams are sparse and limited by small reference populations and outdated methods. The purpose of this study was to establish RIs for hematologic, biochemical, and hormonal analytes in adult rams using controlled preanalytic and analytic procedures, and to investigate whether breed-dependent partitioning of RIs is required. Reference individuals were selected by a direct a priori method. Blood was collected from 128 healthy adult rams representing 2 Greek breeds (64 Chios and 64 Florina). Hematologic analysis was performed on the Advia 120, while differential WBC counts were manually performed on Giemsa-stained blood smears. Flexor E, AVL 9180 Electrolyte Analyzer, and Immulite 1000 were used for biochemical and hormonal analyses, respectively. Combined and breed-specific RIs were calculated using nonparametric and robust methods, respectively. Five outliers were detected based on laboratory results. Partitioning of RIs, based on both statistical and nonstatistical criteria, was recommended for some of the analytes. The RIs are in some agreement with those in the literature. The observed differences may be attributed to preanalytic and analytic factors. The RIs determined in this study can be used as a guide for the interpretation of laboratory results in rams and can potentially be adopted by veterinary laboratories, provided that similar equipment and reagents are used.

Elements of the complete blood count associated with cardiovascular disease incidence: Findings from the EPIC-NL cohort study

All blood cells (white blood cells [WBC], red blood cells [RBC] and platelets) can play a role in atherosclerosis. Complete blood count (CBC) is widely available in clinical practice but utility as potential risk factors for cardiovascular disease (CVD) is uncertain. Our aim was to assess the associations of pre-diagnostic CBC with incidence of CVD in 14,362 adults free of CVD and aged 47.8 (±11.7) years at baseline, followed-up for 11.4 years (992 incident cases). Cox proportional hazards regressions were used to estimate HRs and 95%CI. Comparing the top (T3) to bottom (T1) tertile, increased total WBC, lymphocyte, monocyte and neutrophil counts were associated with higher CVD risk: 1.31 (1.10; 1.55), 1.20 (1.02; 1.41), 1.21 (1.03; 1.41) and 1.24 (1.05; 1.47), as well as mean corpuscular volume (MCV: 1.23 [1.04; 1.46]) and red cell distribution width (RDW: 1.22 [1.03; 1.44]). Platelets displayed an association for count values above the clinically normal range: 1.49 (1.00; 2.22). To conclude, total and differential WBC count, MCV, RDW and platelet count likely play a role in the aetiology of CVD but only WBC provide a modest improvement for the prediction of 10-year CVD risk over traditional CVD risk factors in a general population.

Methimazole-Induced Febrile Neutropenia

Introduction: Antithyroid drugs (ATD) are commonly used for the treatment of thyrotoxicosis, particularly for the treatment of Grave’s disease. Methimazole is the first line ATD. A major fatal adverse effect of ATDs, if unrecognized and not treated on time, is agranulocytosis, which is defined as an absolute neutrophil count of <500/μL. The incidence of ATD-induced agranulocytosis is 0.1%–0.3% (1). In this study, we report on a patient who developed granulocytopenic febrile neutropenia at 3 months after treatment with methimazole (5 mg twice a day per os (BID PO)).Case report: A 51-year-old female patient presented to the emergency department with complaints of fever, fatigue, and productive cough. Her body temperature was 38.5°C; rales were heard on the mid and basal part of the left lung. Drug history revealed methimazole use (10 mg per day over the last 2 months). The WBC count was 1020/μL, and the neutrophil count was 200/μL. The patients’ baseline WBC differential count and immune status were normal. Following inpatient antibiotic treatment and discontinuation of methimazole, the patient became afebrile within 2 days. After 2 weeks of discontinuation of methimazole, we performed CBC and observed the following: WBC, 5180/μL and neutrophil count, 3280/μL.Conclusion: Patients visiting the emergency department with symptoms of a systemic infection and known to use ATDs should be thoroughly evaluated, and the possibility of drug-induced agranulocytosis developing because of the use of these medications should be considered. It is very important for emergency physicians to recognize this rare patient population and act in a timely manner

Physiological consequences of chronic exposure of rainbow trout (Oncorhynchus mykiss) to suspended solid load in recirculating aquaculture systems

High levels of suspended solids, especially fines, are widely regarded as harmful to fish, particularly in recirculating aquaculture systems (RAS) where accumulation of particles is likely. However, little is known about the consequences of chronic exposure to system-related particles on the stress-levels, well-being and health of fish. In this study, the chronic effects of suspended solids on the physiology and performance of rainbow trout were investigated over the growout period, uncoupled from other potentially confounding water parameters. Compared with fish in a control system with a total suspended solid (TSS) load of 3.9mg/L, fish in an otherwise comparable treatment system exposed to minimum particle concentrations of more than 30mg/L exhibited no observable difference in hematological variables (differential leukocyte count, RBC and WBC counts, hematocrit), gill histology, fin condition, or heat shock protein 70 concentrations in gill, liver, skin and head kidney tissues. Slight alterations in feeding behavior and a slight increase in bacterial load on fish and in system water were observed in the treatment RAS, but without any apparent effect on fish performance or health. Furthermore, no significant difference in mortality occurred. The absence of expected effects across a wide range of physiological criteria after long-term exposure suggests that suspended solid levels over 30mg/L are within the physiological tolerance of this species.

The relationship between the welfare quality and stress index in working and breeding horses

The aim of this observational study was to investigate if a relationship exists between the calculated overall individual welfare score (as an indicator of the welfare quality) and the neutrophil:lymphocyte (N:L) ratio (as a stress indicator) in working (draught) and reproduction horses (breeding stallions and broodmares), in two different seasons. The welfare of the horses was assessed by a protocol which included health and behavioural parameters. An individual welfare score was computed, the total and differential WBC count was established and the N:L ratio was calculated for each of the 1482 assessed horses. Using all these parameters, comparisons were made between the horse categories (working horses, breeding stallions, broodmares) in two assessment seasons. Finally, the relationship between the individual welfare score and the N:L ratio was studied in light of the significant correlations found. The highest frequency of health problems was recorded in working horses. The human-animal relationship did not present significant differences between the horse categories. The individual welfare scores were significantly lower (P<0.05) in the working than in the breeding animals, in both assessment seasons. The N:L ratio was significantly higher (P<0.05) in the working horses than in those kept for reproduction. The season had no significant influence (P>0.05) on the investigated parameters. All the significant correlations found between the N:L ratio and the individual welfare score were negative. The results obtained indicate poor welfare in the working horses, comparing with the breeding animals. The findings of our study confirmed that the N:L ratio increases in horses with a poor welfare state. The multiple correlations of the N:L ratio with the individual welfare scores of the assessed horses emphasised the efficiency of this parameter in identifying the acute and chronic stress conditions in the living environment of the animals.

Study of relationship between WBC count and Diabetic complications

Background: There is plenty of evidence to support the fact that inflammation is a risk factor for atherosclerotic diseases and other lifestyle related diseases like diabetes and obesity. Elevated leukocyte count is associated with insulin resistance and is also associated with macro and micro vascular complications in diabetes. This study aimed to investigate the relation between peripheral total and differential WBC count in diabetes and its complications.Methods: This was a cross sectional observational study. It was carried out in the outpatient wing of Department of Medicine, M. G. M. Medical College and M.Y. Hospital. A total of 130 consecutive consenting diabetic patients (type 2) were selected. Those with any obvious stressful condition like acute illness were excluded. All the participants were screened for retinopathy, neuropathy, cerebrovascular disease and cardiovascular disease by history and clinical examination and had their height, weight, waist circumference, hip circumference and white blood cell counts notedResults: In the present study, most of the patients were middle aged patients (46 out of 130 were in age group 51-60 years) and were obese (60/130 had BMI of 26 to 30) with most of them having abdominal obesity (87% males i.e. 48/55 had waist hip ratio &gt;0.90, 56% females i.e. 42/75 had waist hip ratio &gt;0.85). It was found that, amongst 130 patients with type 2 diabetes 56% have WBC counts on the higher side of the normal range i.e. 7000-11000/cu mm. Polymorphs were also on higher side of the normal range in 47% of patients i.e. PMN= 61-70% and 26% had polymorphs above 70%. About 61% patients had monocyte count &gt;6%. Out of the 130 patients, 35 had retinopathy, 57 had neuropathy and 9 had nephropathy as micro vascular complications while as macro vascular complications, 9 had a history of CVA, 14 had CAD and 4 had PVD. Also, maximum patients having micro and macro vascular complications had WBC counts in the range of 7000-11000.Conclusions: An elevated leukocyte count even within the normal range was associated with chronic complications in type 2 diabetes and can be used to predict development of micro and macro vascular complications in patients diagnosed with type 2 diabetes.

Hematologic reference intervals and age effect in European Strigiformes.

The clinical importance of hematologic testing in avian veterinary medicine is reflected in the increasing number of studies for the establishment of hematologic RIs of Strigiformes and other species. Age is an important physiologic factor in birds and the effect on hematology variable should be understood. The objective of this study was to determine baseline data of hematologic variables in 5 species of Iberian Strigiformes in different age classes. Nocturnal birds of prey were sampled at Wildlife Health Centers. Packed cell volume was determined by the microhematocrit centrifugation method, and RBC and WBC counts were determined using the direct hemocytometer count method with Natt and Herrick solution. Hemoglobin concentration was measured spectrophotometrically. The MCV, MCHC, and MHC were calculated using the standard formulas. The differential WBC count was performed by the routine microscopic evaluation of 200 cells on a blood smear manually stained with Wright stain. Thrombocyte blood count estimate was obtained from the blood film. No differences were observed between juveniles and adults for any variable evaluated in Tawny owl, Little owl, Scops owl, Long-eared owl, and Barn owl. In addition, PCV, RBC, and HGB of chicks were statistically significantly lower than in juveniles and adults, and total WBC was significantly higher in Tawny owl, Little owl, Scops owl, and Long-eared owl. Our findings provide evidence that laboratory data from chicks of Strigiformes are different compared to juveniles and adults; therefore, separate RIs were defined.