Smear Examination Research Articles

Clinical and hematological findings in alpacas (Vicugna pacos) with and without Candidatus Mycoplasma haemolamae infection

Anemia is a common problem in South American camelids (SACs). Infections with Candidatus Mycoplasma haemolamae (CMh), a cell-wall free, hemotropic bacterium, are often suspected to be an important cause of anemia, as the pathogen infects the erythrocytes and is found in the blood of up to 30% of SACs. The information on the clinical signs of animals infected with this pathogen vary widely. Most infections are clinically inapparent. Treatment is usually carried out with oxytetracycline. A detailed overview of the clinical and hematological findings in 13 alpacas infected with Candidatus M. haemolamae (CMh+), based on patients from our university clinic and comparing those findings with the results of 22 negative alpacas (CMh−) is provided. Assignment to both groups was based on the PCR result. No relevant clinical or hematological differences between CMh+ and CMh− were found, the clinical signs in CMh+ were usually due to comorbidities. The examination of a blood smear alone proved to be insufficient; a PCR test should be carried out to confirm or rule out an infection. A critical review of the need for antibiotic treatment on the basis of a positive test result alone is recommended.

Antioxidant and Antiplasmodial Potentials of Methanol Bark Extract of <i>Entada africana </i>Via <i>in Vitro</i> Approaches

<i>Plasmodium </i>parasites, which cause malaria, continue to pose a serious threat to global health, necessitating the continuous search for novel antimalarial agents. Oxidative stress has also been linked to the pathophysiology of malaria. <i>Entada africana</i> is a plant known for its ethnomedicinal uses in treating various ailments associated with inflammation including malaria. This study aimed at evaluating the antiplasmodial and antioxidant potentials of methanol bark extract from <i>Entada africana </i>(MBEEA). <i>In vitro </i>approaches were adopted for the study.<i> Plasmodium falciparum-</i>infected erythrocyte samples were cultured in Roswell Park Memorial Institute (RPMI) 1640 media under anaerobic conditions for 72 hours. Eighteen test tubes were labeled and grouped into three replicates per group. Group I (untreated), Group II, and III were treated with chloroquine (CQ) and artemether (AR) at a concentration of 5 mg/dL. Group IV, V, and VI were treated with the extract at respective concentrations of 5 mg/dL, 10 mg/dL, and 20 mg/dL for 72 hours. The parasitemia count and the percentage parasitemia inhibition were determined by microscopic examination of Giemsa-stained smears. The antioxidant potential of the extract was assessed using <i>in vitro</i> assays, including superoxide radical scavenging activity (SRSA), hydroxyl radical scavenging activity (HRSA), 1,1-diphenyl-2-picrylhydrazyl (DPPH), and ferric reducing antioxidant power (FRAP). Microscopic examination of the treated samples revealed varying degrees of parasitemia inhibition. Group II and III treated with CQ and AR demonstrated a considerable reduction in parasitemia count with percentage inhibition of 100% and 83% respectively. The <i>E. africana</i> extract showed a concentration-dependent effect on parasitemia count. At 5 mg/dL, the extract exhibited 50% parasitemia inhibition, which increased to 100% at 10 mg/dL, and 20 mg/dL respectively. The MBEEA demonstrated significant <i>in vitro </i>antioxidant activities by scavenging DPPH, SRSA, and hydroxyl radical compared to the standard antioxidant (ascorbic acid). MBEEA thus exhibit potent antioxidant and antiplasmodial properties. This plant is therefore offers to be a promising medicinal plant in the treatment of malaria, hence it is recommended as potent antiplasmodial plant usable for treating malaria.

Clinical manifestation and management of hypomagnesemia in Theileria spp. infected periparturient Malabari goats

BackgroundGrass tetany or hypomagnesemia is a metabolic syndrome causing acute neurological manifestations in periparturient ruminants grazing on rapidly grown green pastures or cereal crops with high potassium or nitrogen content and low magnesium levels. Clinical reports of naturally occurring grass tetany in goats are least described in the literature and it is considered to be a rare disease. The present study documents the clinical manifestation and management of hypomagnesemia-associated excitatory neuropathy in two Theileria spp. infected Malabari goats presented to the small ruminant medicine OP unit of the University Veterinary Hospital and Teaching Veterinary Clinical Complex, Mannuthy, Thrissur, Kerala, India. MethodsThe first goat was in the last trimester of pregnancy and was showing signs of hyperesthesia, limping, difficulty in standing, and inappetence for the last six hours. The second goat was kidded six weeks back and was showing recurrent epileptic seizures and hyporexia from the previous day. Both the goats were kept on extensive grazing from the forest areas with unidentified lush vegetation. On clinical evaluation, both the goats were showing persistent excitatory neurological signs. Fecal examination, peripheral blood smear examination, PCR screening panel for hemoparasites, Complete Blood Count, and serum levels of calcium, magnesium, and glucose were evaluated. ResultsA significant reduction in serum magnesium levels was noted in both cases along with the varied glucose levels. Theileria spp. infection was noticed in blood smear examination and confirmed by PCR. The goats responded well to the therapy using MIFEX™ and other supportive medications and showed uneventful recovery. ConclusionIt is suggested that the farmers should be vigilant enough while allowing goats to graze in unknown vegetation and prevent indiscriminate fodder intake during periods of drought. This is the first documented report of hypomagnesemic excitatory neurologic symptoms in Theileria spp. infected periparturient Malabari goats and showing response to appropriate therapy.

Storage Induced Alterations in Erythrocyte Morphology and Platelet Count

Background: Examination of blood smears and various hematologic parameters is the first step in assessment of hematologic function and diagnosis of possible underlying diseases. The aim of this study was to identify artefacts in stored red blood cells and classify the occurrence of such alterations according to the age of the stored sample. This studyalso aimed to note the changes in platelet count dispatched by automated hematology coulter in such stored blood samples. Material and Methods: A prospective cross sectional study was conducted from the EDTA anticoagulated blood samples of 100 patients received in the department of Pathology after receiving ethical approval from the institutional review committee. All the samples were analyzed in 4 occasions i.e. within 2 hours, at 24 hours, at 48 hours and at 96 hours. Analysis was carried out by Sysmex 5 part analyzer for platelet counts and the Leishman stained blood films were examined to note changes in the erythroctyte morphology. Results: There was alterationsin platelet counts in 22% cases between 2-hour samples and other samples. The red blood cell morphology was not different among 2 hours samples and 24 hours sample. However, the red blood cell morphology was altered in 48 hours samples and 96 hours samples. Conclusion: Storage of EDTA anticoagulated blood even upon refrigeration can cause changes in platelet counts as well as morphology of red blood cells. Changes in red blood cells are not significant till 24 hours while the platelet counts may alter within 24 hours.

MYH9-related disease with a normal platelet count.

MYH9-related disease (MYH9-RD) is characterized by congenital macrothrombocytopenia, progressive kidney failure, and sensorineural hearing loss. We describe a patient with MYH9-RD and a normal platelet count. A 13-year-old boy with a normal platelet count presented with proteinuria and hematuria and underwent a kidney biopsy. Light microscopy showed mild mesangial matrix expansion. Electron microscopy showed thinning of the glomerular basement membrane and splitting of the lamina densa. A tentative diagnosis of Alport syndrome was made. Unexpectedly, genetic analysis revealed a de novo MYH9 gene variant (p.Gln1068_Leu1074dup). A peripheral blood smear examination showed giant platelets and leukocyte inclusion bodies, confirming a diagnosis of MYH9-RD. In summary, we described a patient with MYH9-RD without thrombocytopenia who showed glomerular basement membrane abnormalities similar to Alport syndrome. Peripheral blood smear examinations may be helpful for an appropriate diagnosis of MYH9-RD, even in patients with proteinuria and a normal platelet count.

Leucémie à plasmocytes secondaire : à propos d’un cas rare et revue de littérature Secondary plasma cell leukemia: a rare case report and review of the literature

Plasma cell leukemia is a hematological malignancy characterized by monoclonal proliferation of plasma cells in the peripheral blood and bone marrow. It is defined by a blood plasma count greater than 2 × 109/L (2G/L) and/or the presence of more than 20% plasma cells in the white blood cell count. There are two forms: the primary or de novo form, which manifests itself immediately as leukemia, and the secondary form , which corresponds to the evolution of a known multiple myeloma. It is a highly aggressive form of plasma cell neoplasm, with a poor prognosis despite therapeutic advances. In this context, we present a rare case of secondary plasma cell leukemia in a 56-year-old female patient, diagnosed at the hematology laboratory of the Hassan II University Hospital in Fez. The patient was being followed for multiple myeloma, for which she was put on chemotherapy according to the Velcade + Thalidomide + Dexamethasone protocol. Six months later, the patient presented with a febrile hemorrhagic syndrome. The blood count showed hyperleukocytosis at 39.4 G/L and bicytopenia (Hemoglobin = 7.9 g/dl, Platelets = 58 G/L). Blood smear showed a 36% plasma cell count suggestive of secondary plasma cell leukemia. At the end of this observation, we underline the crucial importance of regular monitoring by careful cytological examination of the blood smear in all patients followed for multiple myeloma.

A Comparative Study of Peripheral Smear Findings with RBC Indices and Automated Analyzer Generated RBC Histograms in the Diagnosis of Anemia's

Abstract Introduction The red blood cell (RBC) indices generated by cell counters help in the morphological classification of anemia. The importance of microscopic examination of peripheral blood smears (PBSs) stained by Leishman stain cannot be used alone when it comes to interpretation of the underlying cause of anemia. Hence, all three RBC histograms, indices, and microscopic examination of PBSs are very essential for a complete assessment of anemia. Aims and Objectives To diagnose the type of anemia by examination of PBSs, automated cell-generated RBC histograms, and RBC indices and to compare and correlate the findings of RBC indices and automated cell-generated RBC histograms with PBS examination. Materials and Methods This was a prospective comparative study done on 500 cases of anemia for a period of 5 months from August 2023 to December 2023 in a rural tertiary care teaching hospital and all the patients' RBC indices, RBC histogram findings, and PBS findings were noted and analyzed. Results Among 500 samples, normocytic normochromic anemia consists of the majority of the cases 272 (54.4%), followed by microcytic hypochromic anemia cases 183 (36.6%), macrocytic anemia cases 27 (5.4%), normocytic hypochromic anemia were 10 (2%) cases, and dimorphic were 8 cases (1.6%). When compared with RBC histogram, 265 (53.0%) cases showed normal bell-shaped curve, 188 (37.6%) cases showed left shift, 27 (5.4%) cases showed broad based curve, 10 (2%) cases showed right shift, and 10 (2%) cases showed bimodal curve suggesting normocytic normochromic, microcytic hypochromic, normocytic hypochromic anemia, macrocytic, and dimorphic anemia, respectively. Conclusion This study showed a well correlation in the findings of the automated hematology analyzer with the microscopic examination. Histogram alone could be used as a screening method but when combined with RBC indices and PBS findings, they act as useful supplements and by correlating findings of all three, we could diagnose the majority of anemia.

HPV DNA status and clinical history of patients are supplements for accurate reporting of the cytological Pap smear

The present study was aimed at showing the importance of HPV DNA status and the clinical history of the patients required by the cytologist for accurate reporting. A total of 1250 symptomatic women who attended the gynaecology outpatient department of the Mahavir Cancer Sansthan and Nalanda Medical College, Patna, for pap smear examinations were screened and recruited for the study. Due to highly clinical symptoms out of the negative with inflammatory smears reported, one hundred and ten patients were randomly advised for biopsy and HPV 16/18 DNA analysis by a gynaecologist to correlate negative smears included in the study. Pap smear reports revealed that 1178 (94.24%) were negative for intraepithelial lesions (NILM) with inflammatory smears, 23 (1.84%) smears showed low-grade squamous intraepithelial lesions (LSIL), 12 (0.96%) smears showed high-grade squamous intraepithelial lesions, and 37 (2.96%) smears showed an atypical squamous cell of undetermined significance (ASC-US). A biopsy of 110 out of 1178 (NILM) patients revealed that 15 (13.63%) women had cervical cancer, 29 women had CIN I, 17 women had CIN II + CIN III, 35 women had benign cervical changes, and 14 women had haemorrhages. On the other hand, HPV 16/18 DNA was detected as positive in 87 out of 110. The high positivity of HPV in biopsied cases where frank cervical cancer and at-risk cancer were also observed in the negative smear-screened patients reveals that the HPV status and clinical history of the patients will be quite helpful to the cytologist for accurate reporting, and suggests that a negative HPV DNA result may be a stronger predictor of cervical cancer risk than a negative Pap test.

MDS-Type Morphologic Abnormalities of Peripheral Blood Granulocytes in Symptomatic COVID-19 Patients.

Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.

Biochemical, Molecular, Postmortem and Histopathological Characterization of Bovine Theilerioses at Different Stages of Production and Reproduction

Theilerosis is the most important common vector (Tick) born and hemoprotozoan diseases (TBDS) which pose a serious threat to the livestock population in terms of mortality, reduced milk yield and lowered draft power. The disease is having impact on biochemistry and systemic functions affecting at different stages of production and reproduction of dairy cattle as well as there is lack of accurate diagnosis of this disease. A total 1900 cases were suspected for theileriosis on the basis of clinical signs and total 950 cases were found positive for theileriosis on the basis of blood smear examination. As per the stages of pregnancy and lactation, the cases were classified as cows in early pregnancy, cows in late pregnancy, cows in post parturient stage, cows in early and late lactation period. Biochemical alterations like increased AST, ALT and BUN level indicating liver and kidney dysfunctions in all the groups and significantly higher in post parturient group. The serum phosphorus, calcium and magnesium level decreased in all the affected groups and mostly in late pregnancy period and post parturient stage indicating metabolic disturbances during the disease which were aggravated during theileriosis. Through molecular diagnosis 114 cows (65.51%) were found positive for T. annulata and 41 cows (22.9%) were found positive for T. orientalis and 19 cows (10.9%) were found positive for both Theileria annulata and Theileria orientalis. Phylogenetic analysis revealed the accession number for Theileria annulata was OQ230445 which is having 100% similarity with puri isolate and 98% similarity with Khorda isolate and the accession number for T. orientalis was OQ 230446 having 85% similarity with Khorda isolate. On necropsy, the animals were weak, debilitated with atrophy of the muscles. In some cases, the liver was enlarged, markedly congested and in some cases yellowish tinged surface and cut edges with distension of gall bladder was evident. Abomasal ulcers were distinct and considered as pathognomonic. On histopathological examination, the liver revealed necrosis of hepatocytes with sinusoidal congestion and infiltration of mononuclear cells. In lymphnode, there was depletion of lymphocytes in lymphoid follicles with congestion and haemorrhage. Pulmonary edema was also evident in few cases. The combined approach involving biochemical, molecular, Post-mortem and histopathological characters were found to be fruitful in diagnosis of the bovine theileriosis at different stages of production and reproduction with optimum specificity.

Prevalence, risk factors, and hematologic changes in dogs from Baja California with presence of Ehrlichia spp., and coinfection with Anaplasma spp.

Ehrlichia and Anaplasma are obligate intracellular, gram-negative bacteria with tropism for hematopoietic cells, especially leukocytes and platelets. There are several Ehrlichia species that infect dogs. Ehrlichia canis is transmitted by Rhipicephalus sanguineus and replicates within monocytes and macrophages, leading to canine monocytic ehrlichiosis, a disease of worldwide distribution. The clinical signs are varied and non-specific. Anaplasma has two species that infect dogs, Anaplasma phagocytophilum and Anaplasma platys, the second also transmitted by Rhipicephalus sanguineus. This study aimed to evaluate the epidemiology and hematologic changes associated with the presence of Ehrlichia spp. and Anaplasma spp. coinfection in dogs from Baja California. Complete hematological analysis, examination of buffy coat smears, and ELISA tests were performed on blood samples from three veterinary diagnostic laboratories from Mexicali and Tijuana cities in Baja California, Mexico. A total of 5,469 dog samples were analyzed. The overall prevalence of Ehrlichia spp., was 4.79%, with a distribution of 6.3% in Mexicali (OR: 2.39 CI: 1.69-3.17) and 2.5% in Tijuana. The peak of infection was found in September. Contact with other dogs and tick infestation were the risk factors associated with infection (P < 0.05). There was 96% co-infection only in Tijuana and 0% in Mexicali. Anemia, thrombocytopenia, and hyperproteinemia are associated with Ehrlichia spp., and Ehrlichia/Anaplasma infection. In view of the foregoing, we have to maintain epidemiologic vigilance, as well as look further into the ticks present in the state and the possibility of transmission of unusual pathogens.

Annotated Pap cell images and smear slices for cell classification

Machine learning-based systems have become instrumental in augmenting global efforts to combat cervical cancer. A burgeoning area of research focuses on leveraging artificial intelligence to enhance the cervical screening process, primarily through the exhaustive examination of Pap smears, traditionally reliant on the meticulous and labor-intensive analysis conducted by specialized experts. Despite the existence of some comprehensive and readily accessible datasets, the field is presently constrained by the limited volume of publicly available images and smears. As a remedy, our work unveils APACC (Annotated PAp cell images and smear slices for Cell Classification), a comprehensive dataset designed to bridge this gap. The APACC dataset features a remarkable array of images crucial for advancing research in this field. It comprises 103,675 annotated cell images, carefully extracted from 107 whole smears, which are further divided into 21,371 sub-regions for a more refined analysis. This dataset includes a vast number of cell images from conventional Pap smears and their specific locations on each smear, offering a valuable resource for in-depth investigation and study.

Comparative Evaluation of Prostatic Smear and Semen Analysis in The Diagnosis of Chronic Prostatitis

Abstract Background Chronic prostatitis is one of the most common medical problems among andrology and urology patients. Besides being the primary problem in many cases, it seems to play an important contributing role “major or minor” in a significant proportion of patients whether at the level of fertility, sexology or venerology. Consequently, effective management of the prostatic pathology has a great impact on the overall successful management of such andrologic problem. Aim of the Work to provide an objective comparison between traditional prostatic discharge analysis and traditional semen analysis as regards detection of pus cells in cases of prostatitis as well as to assess the possible advantage(s) of applying some modifications to enhance the diagnostic value of the previous techniques. These would include preliminary centrifugation of expressed prostatic discharge and preliminary peroxidase staining of semen sample before microscopic examination. Patients and Methods This pilot study included 40 patients suffering from prostatitis except acute prostatitis. The patients were recruited from the outpatient clinic of Venerology and Andrology department of Ain Shams University Hospitals in the period from February 2021 to November 2021. Results The current study included 40 patients suffering from any kind of prostatitis except acute prostatitis. Their age ranged between 30 and 50 years old with a mean age of 39.60 ± 4.52 years. Duration of disease ranged from 4-18 months with a mean of 7 ± 3.1 months. Most of patients were married (38, 95%). Main symptoms presented among studied patients were groin pain (37.5%), groin pain and painful micturition (20%) and groin pain, painful micturition and sexual problems (42.5%) Conclusion prostatic smear examination revealed higher sensitivity in detection of infection compared to semen analysis especially if combined with centrifugation. In addition, peroxidase positive cell testing revealed a significant role in detection of infection if the diagnosis is made solely on semen analysis results.

Comparison of classification of anemia based on mean corpuscular volume by hematology analyzer and peripheral smear examination

Comparison of classification of anemia based on mean corpuscular volume by hematology analyzer and peripheral smear examination

Free-living amoebic encephalitis - Case series.

Free-living amoeba is ubiquitous in fresh water, mud, and moist soil; although seldom pathogenic to humans, Naegleria fowleri, Acanthamoeba spp., and Balamuthia spp. are known to cause infections of the central nervous system. We report two interesting cases, both of which presented with a rapid-onset and fulminant course. The first case details a 36-year-old male with a history of surgically corrected nasal bone fracture 15 years back, who presented with acute onset of fever, headache and convulsions. Direct smears of cerebrospinal fluid (CSF) revealed motile trophozoites resembling N. fowleri and were later confirmed by molecular diagnosis (polymerase chain reaction [PCR]). Subsequently, the source was identified as water used for religious purposes. Unfortunately, the patient succumbed to cardiac arrest. The second case is that of a 4-year-old boy from Palakkad district, Kerala, who presented with sudden onset of nasal discharge, fever, headache, vomiting, seizures and altered sensorium. His CSF smear examination showed motile trophozoites resembling Acanthamoeba spp. While undergoing treatment, he seized thrice before going into cardiac arrest. Despite extensive resuscitation measures, the child could not be revived and passed away. The postmortem CSF sample sent for molecular analysis confirmed infection by Acanthamoeba spp. Rapid progression and lack of definite treatment options make this a highly fatal condition. Although clinical presentations of both patients were indicative of pyogenic meningitis, parasitic infection was suspected when the CSF was found turbid with no bacteria, high protein, and low sugar. High index of suspicion helped us to get an early preliminary diagnosis from direct microscopy.

Hematoprotective Effect of Eugenol against Iron Overload in Male Rats

This study aimed to evaluate the hematoprotective effects of eugenol against iron overload in male rats. A total of 30 rats were randomly divided into six equal groups as follows: the control negative (C-) group I.P injection distal water. The control positive (C+) group received iron dextran (100 mg/kg-BW) I.P injection. The IE1 and IE2 groups received iron dextran 100 mg/kg-BW I.P and eugenol (50,100 mg/kg-BW) orally, respectively, and the E3 and E4 groups received eugenol (50,100 mg/kg-BW) orally. After 30 days of the experiment, the blood was collected to measure the experimental parameters. The results demonstrated a significant increase in RBCs, Hb percentage, WBCs, PCV, and PTL in the C+ group compared to the C- group. Also, there was a non-significant difference between IE1 and C+ in RBCs and Hb. Meanwhile, PCV decreased significantly in IE1 compared with C+. Conversely, the C+ group showed decreased MCV compared with IE1. Microscopic examination of blood smears indicated normal red blood cell morphology in the C- and iron dextran with eugenol-treated groups, while the C+ group exhibited microcytic hypochromic morphology. In conclusion, the ameliorative effect of eugenol against iron overload-induced hematotoxicity is achieved by restoring the hematological parameters near the normal control.

A Severe Clinical Case of Theileriosis with Terminal Wasting in Adult Cattle: A Veterinary Clinical and Pathology Case Report

This veterinary clinical and pathology case report describes a severe clinical case of theileriosis in adult cattle with prolonged recumbency and terminal wasting because of complications due to chronic theileriosis in two adult (2-year-old) Jersey-Friesian Cross. The case was referred to the large animal clinic of the University Veterinary Hospital (UVH), Faculty of Veterinary Medicine, Universiti Putra Malaysia (UPM). The animals were presented as recumbent, dull, depressed, hypothermic, dehydrated, and cachexic. There were poor responses of the patients to fluid therapy and non-steroidal anti-inflammatory treatments, and they both died within 24 hrs of clinical presentation. Haematology (complete blood count and serum biochemistry) results revealed haemoconcentration and faecal examinations were negative for liver fluke infestation and blood smear examination was positive for intraerythrocytic piroplasms of Theileria (0.01% parasitaemia). Post-mortem examination further revealed advanced cachexia, generalised serous atrophy of fat, hepatomegaly, hepatic congestion, pulmonary congestion, and pulmonary oedema. Histological findings revealed atrophy of the hepatic cord, hepatic congestion, splenic hemosiderosis, pulmonary oedema and congestion. The clinicopathological findings supported an aetiological diagnosis of a severe clinical case of Theileriosis with terminal wasting because of complications due to chronic Theileriosis infection.

A study of etiological spectrum in 106 cases of pancytopenia

Introduction and aim. Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. The aim of this work was to study the etiological spectrum of pancytopenia in the National capital region of India, and evaluate the relationship of pancytopenia with serum vitamin B12 levels. Material and methods. This study is of a prospective and analytical type conducted on patients attending the outpatient and inpatient department of Santosh Medical College and the Saraswathi Institute of Medical Sciences tertiary care centers in NCR. Complete blood counts and peripheral blood smear examination was used for morphological classification and typing of anemia. Bone marrow aspiration and vitamin B12 estimation was performed where required. Results. The maximum number of pancytopenia cases were etiologically attributed to megaloblastic anemia (64.2%) followed by aplastic anemia (19.8%). Malaria was attributed to 6.6% cases of pancytopenia. Iron deficiency anemia and tuberculosis both accounted for 1.9% of cases. each. A history of drug intake and mixed nutritional anemia each contributed to 2.8% of cases. Serum vitamin B12 levels showed a significant relationship with pancytopenic cases. Conclusion. In our study, the main cause of pancytopenia is megaloblastic anemia which responds very well to treatment if diagnosed correctly in time. A detailed hematological assessment along with vitamin B12 levels should be evaluated in all cases of pancytopenia irrespective of the etiological categorization.

The incidence of TP53 mutations in patients with chronic lymphocytic leukemia in Iran

Objectives Chronic lymphocytic leukemia (CLL) is linked to a highly variable disease course regarding responses to chemoimmunotherapy and clinical outcomes. Mutations in TP53 and/or deletions in chromosome 17p locus [del(17p)] may lead to loss of a TP53 allele. We investigated TP53 mutations in patients with CLL. Material and Methods Thirty patients with CLL, aged 40–84 years, were included. Immunophenotyping of B cells was done using flow cytometry by CD5, CD10, CD19, CD20, CD23, CD49d, CD38, FMC7, and CD200 markers. Bone marrow aspiration and peripheral blood smear examination were also performed. DNA was extracted and sequencing was done using the Sanger method. Structural aberrations were investigated using the FISH method. Results TP53 mutations had a frequency of eight cases (23.3%), three of which were missense mutations (37.5%), three were intronic mutations (37.5%), and two were silent mutations (25%). Peripheral B lymphocytes had a mean of 82% with 4.59% prolymphocytes. Conclusion Accurate testing for TP53 mutations [TP53 and del(17p) mutations] before every treatment line enables us to make proper therapeutic decisions to improve patient outcomes.

A Cross-sectional Study of Prevalence of Gastrointestinal Parasites in Captive Wild Animals in Pakistan Zoological Gardens

The animals held captive in zoos often face health and well-being issues. Parasitic infections can lead to health problems in wildlife animals by affecting their gastrointestinal tract. Therefore, the present study aimed to identify and evaluate the population of the various Gastrointestinal (GIT) parasites of wild animals enclosed in different zoological gardens in Pakistan. The fresh fecal samples (n = 960) of 20 captive wildlife animals were collected from Marghzar Zoo, Islamabad (n = 340), Ayub National Park, Rawalpindi (n = 221), Lohi Bher Wildlife Park, Rawalpindi (n = 296), and Bansra Galli Wildlife Park, Rawalpindi (n = 103). The samples were obtained from wildlife mammals, including urial (n = 95), blue bull (n = 106), chinkara gazelle (n = 77), zebra (n = 77), hog deer (n = 75), spotted deer (n = 43), blackbuck (n = 58), barking deer (n = 52), red deer (n = 104), yak (n = 44), grey goral (n = 40), lion (n = 37), mouflon sheep (n = 46), red fox (n = 12), bear (n = 37), grey wolf (n = 12), jackal (n = 12), vervet monkey (n = 12), rhesus monkey (n = 12), and langoor (n = 12). Various methods, such as direct smear examination, standard sedimentation, and floatation techniques were applied to detect and identify the endoparasites in the fecal sample. The detailed routine parasitological analysis identified approximately 52 endoparasites in the fecal samples, including Haemonchus contortus, Eimeria bovis, Ostertagia curcumcincta, Strongyloides papillosus, Strogylus equinus, Oxyuris equi, Chabertia ovina, Protostrongylus, and Trichostrongylus vitrines. The obtained results indicated that Lohi Bher Wildlife Park (46.35%) had a higher prevalence of GIT parasites, compared to Marghzar Zoo (33.23%), Bansra Galli Wildlife Park (33.02%), and Ayub National Park (19.45%). The study reports mild to moderate parasitic infection in captive wild animals and that could affect the survivability of the animals in captivity. The findings of the study can be used to formulate a proper health protocol and sanitation management in captive wild animals to control parasitic infections.