Cell Hb Research Articles

Transcriptomic analysis of the human habenula in schizophrenia.

Transcriptomic analysis of the human habenula and identification of molecular changes associated with schizophrenia risk and illness state.

Association of the Red Cell Distribution Width with Complete Blood Count, Glycated Hemoglobin and Vitamin D in Patients with Type 2 Diabetes Mellitus- Across Sectional Study

The current study was aimed to assess the association of the Red Cell Distribution Width (RDW) with Glycated haemoglobin (HbA1C) and Vitamin D in Patients with Type 2 Diabetes Mellitus to provide insight into the potential physiological mechanisms and predictive significance of RDW fluctuations in patients with heart failure who are diabetic. Material &Methods: The cross-sectional design of this study was utilized to investigate a cohort of 150 patients who had received a diagnosis of type 2 diabetes mellitus. The assessment centered on the evaluation of comorbidities, red cell distribution width (RDW), and glycemic management in addition to vitamin D levels. Information was gathered via questionnaires, encompassing demographic details as well as medical history. Blood samples were assessed for RDW, total blood count, HbA1c, and Vitamin D concentrations using automated analyzers. The statistical analysis was performed utilizing version 27 of SPSS. Results: The study found low relationships between HbA1c and Vitamin D (r = -0.033, p = 0.691), RDW and HbA1c (r = -0.046, p = 0.573), and RDW and Vitamin D (r = -0.128, p = 0.118). Furthermore, Vitamin D had diverse connections with CBC values, suggesting a complex link within the setting of type 2 diabetes mellitus. Conclusion: The findings of the current study indicated an association between the RDW and RBCs, Hb and Red blood cell indices (HCT, MCV, MCH and MCHC) in patients with T2DM. The RDW could therefore serve as potential marker for the management of patients with T2DM.

Semen and haematological characteristics of cocks drenched varying levels of Turmeric Powder (TP)

Emerging evidence from in vivo as well as in vitro studies indicates that botanicals play noteworthy roles in the treatment, prevention and management of livestock diseases. Use of natural compounds in botanicals has been proposed as potential alternative to conventional therapeutic options. Therefore, this study aimed to evaluate the effect of varying levels of turmeric powder (Curcuma longa) on semen characteristics and haematological indices of cocks. Turmeric (C. longa) rhizomes were obtained from a local market in Saki in Oyo State, Nigeria, in March 2023. They were washed, skin scraped and air-dried at room temperature for 10 hours, and then oven-dried at 40°C for 12 hours. Afterwards, the dried turmeric rhizomes were ground into powder using a blender. The product was kept in an air-tight container until use. The experimental material was drenched at 0.00 g (T1), 0.50 g (T2), 1.00 g (T3) and 1.50 g (T4) after 2 weeks of acclimatization. Semen volume, sperm cell progressive motility, sperm cell liveability, acrosome integrity, sperm cell concentration and normal sperm cell were evaluated for semen characteristics. Haematological parameters measured were: PCV, RBC, WBC Hb, MCV, MCH, MCHC and white blood cell differentials. Data obtained were subjected to one-way analysis of variance. Semen volume (0.34 – 0.37 ml), sperm cell progressive motility (68.33 – 80%), sperm cell liveability (46.66 – 85.00%), acrosome integrity (50.00 – 85%) and normal sperm cell (66.66 – 90%) showed significant difference (p<0.05) in favour of cocks on highest level (1.50 g) of turmeric powder, while sperm cell concentration (28.33 - 40.00 X109/ml) showed no significant difference (p>0.05). Also PCV (36.00 – 40.33%), RBC (3.55 – 3.74 X106/ml), WBC (19.01 – 19.71 X109/ml), Hb (11.66 – 13.00 dl), MCV (100.53 – 109.53 ⴄ), MCH (32.57 – 35.31pg) and MCHC (32.00 – 32.37%) showed no significant differences (p>0.05) between treatments. In conclusion turmeric powder up to 1.50 g showed an improvement in all the semen characteristics measured without negative effect on haematological characteristics of cocks.

Presentation of Acute Pancreatitis in Sickle Cell Disease Patients: A Single Hospital Experience.

Sickle cell disease (SCD) is a haemoglobinopathy that leads to the formation of distorted sickle-shaped red blood cells that are prone to vaso-occlusion. This may lead to vaso-occlusive crises that may affect any organ. Acute pancreatitis (AP) in SCD patients may be mimicked by a vaso-occlusive crisis in the abdomen. The objective of this article is to analyse the clinical profiles of SCD patients with AP and understand the differences in the presentation of AP compared to an abdominal vaso-occlusive crisis and the difference between its presentation in SCD patients in comparison to other patients. Twenty-eight SCD patients who were diagnosed with AP during their admission to the paediatric department at a tertiary hospital between January 2012 and December 2020 were retrospectively studied. Patients aged older than 14 years were excluded. The data collected concerned: demographics, the clinical course and the hospital course. The diagnosis and severity protocols followed the revised Atlanta Criteria. The patients were aged with a mean of 9.61 years. There were 15 males and 13 females. Demographics were not significantly correlated to complication rates (P > 0.05). The mean duration of hospitalisation was 6.43 days. The most common clinical presentations were abdominal pain, fever, then vomiting and nausea. Three patients experienced complications and they were all cases of cholangitis (10.71%). There were no cases of pseudocysts, acute necrotic collections, pancreatic or peripancreatic necrosis or walled-off necroses. All of the cases of AP in SCD children were mild according to the revised Atlanta classification. Leucocytosis was present in 29.29% of patients and 17.8% of patients had high C-reactive proteins (CRPs). There was no significant correlation between leucocyte counts, CRP levels, serum or urinary amylase levels and complications (P > 0.05). All patients had haemoglobin (Hb) levels above 7 g/dL. The levels of sickle Hb ranged from 40 to 70 g/dL and reticulocyte counts averaged at 3.57%. Haematologic parameters were not significantly correlated with complication rates (P > 0.05). There were no recurrences. AP in SCD patients presented with classic signs and symptoms. There were no associations between demographics and complications. The levels of leucocytes, CRP counts and serum and urinary amylase were not correlated with complications. The level of Hb and sickle cell Hb was not associated with complication rates. Reticulocytes were slightly elevated in SCD patients with AP. More studies are needed to demarcate factors distinguishing AP in SCD from abdominal vaso-occlusive crises.

Effect of covi-soup on CD4 cell count and haemoglobin among patients with diabetes type II and hypertension in Kakamega county, Kenya: A randomized control trial

Type II diabetes mellitus (DM) and hypertension (HTN) diseases are part of the world’s challenges in achieving sustainable development goals. Cases of type II diabetes mellitus and hypertension diseases in low and middle-income countries are becoming a concern. Type II diabetes mellitus is an inflammatory disease. When there is inflammation the immune system is triggered and haemoglobin level is affected. While there have been numerous strategies to address the issue, these efforts have not been sufficient to guarantee a reduction in disease severity. This was an experimental study conducted in Kakamega County, Kenya. It employed a randomized control trial approach, with two groups: treatment and control. Systematic random sampling was used in identifying participants and simple randomization was used to allocate the respondent to the intervention groups. Sample sizes of 34 (treatment group) and 30 (control group) were used to produce quantitative data. This study evaluated the effect of COVI-soup on haemoglobin (Hb) and cluster of differentiation 4 (CD4) cell count of patients living with both type II diabetes mellitus and hypertension. The treatment group received COVI-soup (a soup composed of butternut squash, ginger, garlic, sunflower pepper, chia seeds and turmeric) while the control group was on a rice soup. Statistical Packages for Social Science (SPSS) version 20 was used in the data analysis. A paired student t-test was used to determine the effect of COVI-soup on Hb and CD4 cell count. There was a positive effect in CD4 cell count in the treatment group (P =0.001) whereas there was no significant effect in the control group (P =0.267). The mean change in CD4 cell count in the treatment group was 97 cells/ul and in the control 75 cells/ul. There was a positive effect (increase) on hemoglobin levels in the treatment group (p=0.0001) whereas there was no significant effect in the control group (p =0.126). The hemoglobin mean change in the treatment group was 3.9 g/dl and in the control 0.5 g/dl. Therefore, COVI-soup had a positive effect on hemoglobin and CD4 cell count levels among patients with both hypertension and type II diabetes mellitus. Key words: Hemoglobin, CD4 cell count, COVI-soup, Rice soup, diabetes type II, hypertension

MiR-451a and let-7i-5p loaded extracellular vesicles attenuate heme-induced inflammation in hiPSC-derived endothelial cells.

Hemolysis is associated with many pathologies, including trauma, sepsis, hemorrhagic stroke, malaria, and genetic disorders such as sickle cell disease (SCD). When hemolysis occurs, free-heme drives vascular inflammation, resulting in oxidative tissue damage and cardiometabolic complications. A better understanding of heme clearance and detoxification is essential to preventing sustained tissue damage. Human induced pluripotent stem cell (hiPSC)-derived endothelial cells (hiPSC-ECs) provide a novel source of patient-specific cells and tissues for disease modeling, drug discovery, and regenerative therapeutics. Here we report the use of hiPSC-ECs to elucidate the role of miR-451a and let-7i-5p-loaded extracellular vesicles (EVs, such as exosomes) in the inflammatory response to free-heme as a model for heme-induced inflammation. We provide evidence of a significant correlation between miR-451a and let-7i-5p-loaded circulating exosomes in plasmodium-infected patients with reported clinical benchmarks of malaria-severity (e.g., Hemoglobin (Hb) levels, white blood cell counts). Additionally, we determined that exposure of Plasmodium falciparum (Pf) parasites to EVs, loaded with either miRNA, significantly reduces their counts in vitro. Using hiPSCs derived from individuals with wild-type Hb (HbAA) or homozygous sickle cell mutated Hb (HbSS) genotypes, we demonstrate that heme-treated hiPSC-ECs secreted inflammatory products (cytokines, chemokines and growth factors) into supporting media at concentrations that were similar to that reported in HbAA and HbSS serum. This inflammatory response was attenuated by exposure with miR-451a or let-7i-5p-loaded EVs. We also found a decrease in transcription of ICAM1 and P-Selectin, as well as the secretion of key inflammatory cytokines (e.g., CXCL10, TNF-α, and IFN-γ). Based on these findings, we propose a model in which increased levels of exosomal miR-451a and let-7i-5p in Plasmodium-infected individuals will attenuate inflammatory responses to free-heme and parasite-derived products. As a result, infected erythrocytes will less likely adhere to the endothelium, sequester in brain micro vessels, and reduce vaso-occlusive crises that exacerbate cerebral malaria.

Cross-Sectional Associations of Body Adiposity, Sedentary Behavior, and Physical Activity with Hemoglobin and White Blood Cell Count.

This study examined whether hemoglobin (Hb) and white blood cell count (WBC) associate with body adiposity and other cardiometabolic risk factors, as well as accelerometer-measured sedentary behavior (SB) and physical activity (PA), when adjusted for body mass index (BMI). The cross-sectional analysis included 144 participants (42 men) with a mean age of 57.0 years and a mean BMI of 31.7 kg/m2. SB and standing time, breaks in sedentary time and PA were measured during four consecutive weeks with hip-worn accelerometers. A fasting blood sample was collected from each participant during the 4-week measurement period and analyzed using Sysmex XN and Cobas 8000 c702 analyzers. Associations of WBC, Hb and other red blood cell markers with cardiometabolic risk factors and physical activity were examined by Pearson's partial correlation coefficient test and with linear mixed regression models. In sex- and age-adjusted correlation analyses both BMI and waist circumference correlated positively with Hb, WBC, red blood cell count (RBC), and hematocrit. Hb was also positively correlated with systolic blood pressure, insulin resistance scores, liver enzymes, LDL, and triglyceride levels. Sedentary time correlated positively with WBC, whereas standing time correlated negatively with WBC. Lying time correlated positively with WBC, RBC, hematocrit, and Hb. Regarding SB and PA measures, only the association between lying time and RBC remained significant after adjustment for the BMI. We conclude that body adiposity, rather than components of SB or PA, associates with Hb levels and WBC, which cluster with general metabolic derangement.

Determination of hematological response to iron and folic acid supplementation among the expectant mothers attending Kakamega County Referral Hospital, Kenya

Background Despite iron and folic acid supplementation program among expectant mothers while attending antenatal care clinic at Kakamega County, the rates of maternal and fetal morbidity and mortality due to anemia complications are still high. Aim First, we determined changes in hematological profiles following iron and folic acid supplementation. Second, we determined association between hematological changes with demographic and clinical characteristics in response to iron and folic acid supplementation. Patients and methods Full hemogram and reticulocyte profiles of 127 expectant mothers were determined at baseline and endpoint after 1 month of iron and folic acid supplementation. Full hemogram profiles were measured using a Maxim 3010 fully automated hematology analyzer, whereas reticulocyte profiles were examined microscopically at ×100 magnification. Demographic data were collected using pretested structured questionnaires. Results The end point measures of red blood cells, hemoglobin (Hb), hematocrit, mean cell volume, reticulocyte count, reticulocyte production index, and absolute reticulocyte number among the anemic mothers were significantly higher relative to baseline levels. Among nonanemic mothers, Hb and mean cell volume levels differed significantly between baseline and end point of the study. The change in erythropoietic response and adequate Hb response was significantly associated with adherence to iron and folic acid supplement. Conclusion Hematological profiles significantly changed especially among anemic mothers following iron and folic acid supplementation. Adherence to supplement is associated with positive erythropoietic response and adequate Hb response.

Effect of Ethanolic Leaf Extract of Vernonia amygdalina on Haematological Parameters in Albino Rats

It has been demonstrated that Vernonia amygdalina, often known as the bitter leaf, offers a range of medical benefits that can improve human health. This study was designed to investigatethe effects of V. amygdalina (VA) ethanolic leaf extracts on some haematological parameters in albino rats. A total of thirty - six albino rats fed with a commercial pelleted poultry grower’s mash- diet were used for this study and they were divided into six groups, each containing six rats. Groups 1, 2, 3, 4 and 5 received 10, 20, 30, 40 and 50 mg/kg body weight (bwt) of VA leaf extract three times a week at two-day intervals over a period of three weeks. Group 6 (control) received water only. The haematological parameters (red blood cell count (RBC), haemoglobin (Hb), packed cell volume (PCV), total white blood cell count (TWBC), platelet (PLT) count, and WBC differentials (neutrophils, lymphocytes, and mixed cells) were analyzed using three part full blood count autoanalyzer. The results showed that although the mean neutrophil count differed significantly (p<0.05) when compared between the groups studied, there was no statistically significant (p>0.05) difference in the mean levels of PCV, Hb, RBC, TWBC, platelet count, lymphocytes and mixed cell count when compared across and between the groups. This study revealed that Vernonia amygdalina had no negative effects on the haematological indicators studied.

Prevalence of neutropenia among adult Arabs in Qatar: Relation to other hematological parameters and anthropometric data.

Neutropenia ranges from a normal variant to life-threatening acquired and congenital disorders. This study aims at providing baseline information regarding the prevalence and spectrum of neutropenia in the Arab blood donors who are living in Qatar. This retrospective cohort study was conducted to review the data of healthy Arab individuals (≥18 years) who donated blood between January 1, 2015 to May 15, 2019. A complete blood count was performed using automated analyzers. The prevalence of neutropenia was 10.7%. The prevalence in females was 32% and in males, it was 6%. Absolute neutrophil count (ANC) below 1 × 109/L was detected in 10% of Arab females and 1.8 % of Arab males. In females, the neutropenic group had significantly lower hemoglobin (Hb) levels and higher red cell distribution width, and lower total white blood cells and lymphocyte counts (P < .001) compared to the group with ANC > 1.5 × 109/L. Significant correlations were found between the ANC and Hb (r = 0.33, P < .05) and ANC and total white blood cells (r = 0.45, P < .01). The prevalence of neutropenia is considerably high in Arab adult females compared to other ethnic groups. Besides the genetic constitution of Arabs, the lower Hb and higher red cell distribution width in females suggest that iron deficiency could contribute to the development of neutropenia.

The function of Piezo1 in hepatoblastoma metastasis and its potential transduction mechanism

BackgroundHepatoblastoma (HB) is the most common primary malignant liver tumor in children. The prognosis of HB metastasis is poor, despite the increasing diversity of treatment. Piezo, a ubiquitously expressed membrane mechano-transduction protein, is involved in the process of tumor cell migration. Under the gene expression profiling interactive analysis (GEPIA) database, Piezo1 was highly expressed in HB and negatively correlated with the overall survival time. MethodsFirstly, the expression of Piezo1 in both paracancerous and HB tissues (n = 7) was detected, and the prognostic value of Piezo1 was assessed in HB (n = 160) patients. Secondly, the inhibition and overexpression of Piezo1were executed in two HB cell lines, HepG2 and Huh 6. Methyl thiazolyl tetrazolium (MTT), wound healing and trans-well assays were performed to identify the effect of Piezo1 on the proliferation and metastasis of HB cells, respectively. In addition, a co-immunoprecipitation assay was performed to determine whether Piezo1 has an interaction with HIF-1α. Finally, the expressions level of Piezo1, HIF-1α, and VEGF by overexpression/inhibition each other were detected by RT-qPCR and western blots to find a possible signaling channel in HB metastasis. ResultsWe found that Piezo1 was highly expressed in HB tissues and associated with poor prognosis of patients. Piezo1 was related to cell proliferation in HepG2 and Huh 6 cells. We also found that Piezo1 stimulated HIF-1α expression. Meanwhile, overexpression of Piezo1 promoted the migration and invasion of HB cells, while the promotion was not detected when HIF-1α was suppressed. Additionally, the silencing of HIF-1α inhibited the expression of VEGF, but showed no effect on Piezo1 expression. ConclusionIn this study, we identified that Piezo1 was involved in HB metastasis, and the Piezo1-HIF-1α-VEGF axis could be a possible signaling pathway in HB metastasis.

A Decrease in Hb and Hypoproteinemia: Possible Predictors of Complications in Neonates with Late-Onset Sepsis in a Developing Country.

ObjectiveThe main purpose of our study was to determine the predictors of complications in neonates with late-onset sepsis (LOS).Materials and methodsThis was a retrospective cohort study conducted in a neonatal intensive care unit between June 2016 and February 2020. Neonates with LOS were enrolled in this study. According to whether complications were merged after LOS, neonates were divided into a complicated group and a noncomplicated group. The demographic data, perinatal conditions, blood cell count analysis, blood cultures, hypoproteinemia within 1 week after the onset of sepsis and treatment measures were compared between the groups.ResultsA total of 87 neonates with LOS were enrolled in this study. Significant differences were observed between the complicated and noncomplicated groups with regard to hemoglobin (Hb), a decrease in Hb, hypoproteinemia and red blood cell transfusions (P < 0.05). Further comparison found that neonates with LOS who had moderate or severe anemia at the time of sepsis onset were more likely to have complications than those with mild or no anemia. The results of binomial stepwise logistic regression suggested that a decrease in Hb (OR=0.045, P=0.025 < 0.05) and hypoproteinemia (OR=0.266, P=0.007 < 0.05) were independent predictors of complications in neonates with LOS. A receiver operating characteristic analysis showed that the area under the curve was 0.807 for a decrease in Hb.ConclusionA decrease in Hb and hypoproteinemia were independent predictors of complications and may help to predict the occurrence of complications in neonates with LOS in the early stage.

Preliminary study on the utilization of aqueous bark extracts of Khaya ivorensis in diets of Clarias gariepinus fingerlings

Mortality of fish seeds is recognised as one of the major factors responsible for serious economic losses in fish culture business. A preliminary investigation on the effects of aqueous extracts of dried African mahogany, Khaya ivorensis bark on the growth, survival, haematology and histology of Clarias gariepinus fingerlings was conducted. A total of 135 C. gariepinus fingerlings (1.41±0.03 g/fish) were randomly allocated into three treatments, T1 (Control), T2 and T3, and fed with three different diets (40% CP) D1, D2 and D3 containing 0g/L, 25g/L and 50g/L aqueous extracts of K. ivorensis bark respectively. The experimental fish were fed ad-libitum for a period of 28 days in rectangular plastic containers (15x25x30cm3 ) and water exchange was done daily. Experimental data were analyzed for statistical differences in the growth, survival indices, haematology and histology of experimental fishes using analysis of variance (ANOVA). There was no significant difference (p&gt;0.05) in mean weight gain of Control (2.91±0.68g) and T2 (2.20±0.20g) but T3 (1.79±0.39g) was significantly low. There was a significant difference in the survival (S) of experimental fish with the S (%) values of 73.67±13.50, 68.67±16.50 and 57.00±10.00 for T2, T3 and control respectively, no significant different in the feed conversion ratio (p&gt;0.05) in the experimental groups. The haematological characteristics of all experimental fish were not significantly different, though the packed cell volume, PCV (%), haemoglobin count, HB (g/dl) and red blood cell, RBC (million/mm) were in the order T2˃T3˃Control having mean values of 22.71±4.5˃21.67±5.1˃19.67±1.53 (PCV); 22.67±4.51˃2.67±6.51˃19.67±1.53 (HB) and 2.09±0.47&gt;1.99±0.57&gt;1.73±0.13 (RBC) for T2, T3 and control respectively. The white blood cell, (No/mm) was highest in T1 (4.03±0.25) and least in T3 (3.67±1.35). Although there was no degeneration, the histological characteristics of liver of the experimental fish ranged from moderately diffused to fewer hepatocytes when compared to the normal liver, of the control. It is therefore concluded that Khaya ivorensis bark can be included in the diet of Clarias gariepinus fingerlings at 25g/L aqueous extract for good growth and high survival rates of fish under culture&#x0D; Keywords: Medicinal herbs, Extracts, African catfish, Fish culture

The relationships between routine admission blood tests and burn size, and length of stay in intensive care unit

Although blood test is a routine in major burns, its relationship with burn size and intensive care unit length of stay (ICULOS) remains undetermined. We investigated the feasibility of using these tests as a reference for definite diagnosis of major burn size, burn size >20% of the total body surface area (TBSA), and their relationships with ICULOS. Data of routine laboratory blood tests within 24h after burns (n=73) were collected retrospectively. Correlation tests and regression analyses were performed. Burns ≥20TBSA had higher incidences of leucocytosis, hypoalbuminaemia, elevated haemoglobin (Hb), and elevated haematocrit (Hct). Burn size was correlated negatively with albumin but positively with Hb, Hct, and white blood cell (WBC) count. For each unit increase in blood urea nitrogen (BUN)/creatinine (Cr), there was an increase of 1.2 days of ICULOS in females, while in males, there was a 6.7 day increase for every unit increase in Hb and a 3.1 day increase for each unit increase in BUN. A female model including Hb and WBC was derived, discriminating burns ≥20TBSA with sensitivity and specificity 0.94 and 1.0 respectively, and area under the receiver operating characteristic curve (AUROC) 0.96 (95% CI 0.91-1.00). The male model had sensitivity 0.96, specificity 1.0, and AUROC 0.96 (95% CI 0.89-1.00). Admission Hb and WBC could be used as a reference for definite diagnosis of major burn size, especially in borderline cases. BUN/Cr in females, and Hb and BUN in males, were related to ICULOS.

Extracellular vesicles of first trimester trophoblast cell line overexpressing VPAC2 induce anti-inflammatory signals in HB cell and maternal monocytes

Extracellular vesicles of first trimester trophoblast cell line overexpressing VPAC2 induce anti-inflammatory signals in HB cell and maternal monocytes

Assessment of pre and post donation changes in hematological parameters and serum calcium and magnesium levels in plateletpheresis donors.

Background:Single donor platelet products are preferred over random donor platelet products due to several advantages. However, safety issues with regard to post procedure hematological decrements and serum calcium and magnesium levels in donors undergoing plateletpheresis have been explored minimally.Aims:This prospective study was done to analyze the effects of plateletpheresis on donor’s hematological parameters and serum calcium and magnesium levels.Settings and Design:It is a prospective, cross-sectional study conducted in the department of immunohematology and blood transfusion.Material and Methods:This study was undertaken on 150 healthy plateletpheresis donors over a period of 1 year. Blood samples were collected from each donor before and after the procedure, one in ethylenediaminetetraacetic acid (EDTA) vial for estimation of hematological parameters and another in plain vial for serum calcium and magnesium levels.Statistical Analysis Used:Paired t-test was used to analyze the data.Results:This study included donors in the age group of 18 to 60 years who underwent plateletpheresis on Haemonetics model of a machine (MCS) + intermittent flow cell separator. A statistically significant increase was observed in mean post procedural Hb (0.95%), Hct (0.7%), and red blood cell (RBC) count (1.3%). There was a decrease in mean post procedural platelet count (27.5%), white blood cell (WBC) count (4.02%), mean serum calcium (1.5%), and serum magnesium (5.1%), which was statistically highly significant (P < 0.001). No significant change was observed in post procedural mean platelet volume (MPV) and platelet distribution width (PDW).Conclusion:Amid the need of increased demand for plateletpheresis, donor safety must be ensured. Failing to do so can be detrimental to blood supply chain, hence stringent programs for post donation screening of plateletpheresis donors need to be established.

The Elderly Nutritional Index for Geriatric Malnutrition Assessment (ENIGMA): concurrent, construct and predictive validity in an external evaluation cohort of community-dwelling older persons.

We previously developed a malnutrition risk index, the Elderly Nutritional Index for Geriatric Malnutrition Assessment (ENIGMA) with good predictive accuracy for mortality risk in an original population cohort (SLAS1). Herein, we further evaluate the concurrent and predictive validity of the ENIGMA construct in an external validation cohort (SLAS-2) of 2824 community-dwelling older adults aged 55+ years. They were assessed on the ENIGMA index, Mini Nutritional Assessment-Short Form (MNA-SF) and the Geriatric Nutritional Risk Index (GNRI), known correlates of malnutrition, and baseline and follow-up functional dependency and 10-year mortality risk. Higher ENIGMA risk categories were significantly associated (P < 0·001) with lower education, living alone, smoking, low physical activity, BMI < 18·5 kg/m2, poorer muscle strength and functional mobility, exhaustion, physical frailty, homocysteine, glomerular filtration rate, Hb, red and white blood cell counts, platelets, systemic inflammation indexes, metabolic syndrome, CVD, cognitive impairment and depressive symptoms (Geriatric Depression Scale ≥ 5). ENIGMA scores showed statistically significant (P < 0·001) correlations but low-to-moderate concordance with MNA-SF (r = 0·148, agreement = 45·9 %, kappa = 0·085) and GNRI scores (r = 0·156, agreement = 45·8 %, kappa = 0·096). Controlling for known correlates of malnutrition, only high-risk ENIGMA among the indexes significantly predicted baseline functional dependency (OR = 1·64, 95 % CI 1·01, 2·65) and mortality (hazard ratio = 1·65 (95 % CI 1·04, 2·62). ENIGMA marginally out-performed MNA-SF and GNRI in predicting baseline functional dependency (AUC: 0·625 v. 0·584 v. 0·526), follow-up functional dependency (AUC: 0·594 v. 0·525 v. 0·479) and 10-year mortality risk (AUC: 0·641 v. 0·596 v. 0·595). The concurrent and predictive validity of the ENIGMA construct is replicated in an external evaluation study of community-dwelling older persons.

Comparison of Two Techniques Used for the Evaluation of Point-of-Care Methodology for Testing Hemoglobin in Blood Donors

Background and Objectives: Precise measurement of Haemoglobin(Hb) is necessary before the blood donation procedure for donor's protection against anemia and to ensure blood elements' quality to ensure the better effect of these blood constituents on the clinical outcomes of recipients. This is a comparative analysis of DiaSpect Tm and AccuSure hemoglobin (Hb) for point-of-care technique (POCT) for testing of Hb and to evaluate their effectivness by using venous blood as sample and Sysmex XP100 cell counter as the reference method. Methods: A total of 544 samples of blood donors between the age group 18 and 65 years were taken for this study. Measurement of Hb was done with the use of three different Hb analyzers – DiaSpect Tm, AccuSure Hb (Model HB101), and Sysmex XP100 Cell counter by using venous blood samples. P &lt; 0.001 was taken statistically significant. Results: AccuSure Hb was found to have lower sensitivity in Hb estimation in the donor's blood compared to that of the DiaSpect Tm analyzer. Among various available techniques, there is a requirement to find a more appropriate technique for the estimation of Hb in the donor's blood. Conclusion: We found that DiaSpect Tm has greater sensitivity in comparison to AccuSure Hb. Furthermore, specificity, positive predictive value, negative predictive value, and accuracy of DiaSpect Tm were greater in comparison to those of AccuSure Hb.

Stopping Folic Acid Supplementation in Hydroxyurea Treated Children with Sickle Cell Disease

Daily folic acid supplementation for all children with sickle cell disorders is a widely used preventative measure in UK practice. However, a Cochrane review in 2016 concluded there is little evidence for this practice (CD011130). The only randomised clinical trial of folate supplementation in children, conducted in 1983, showed no evidence of benefit. (Rabb et al. ,1983).More convincing evidence as to the benefits of hydroxyurea and penicillin exists. However, adherence to these effective therapies can be a problem. We hypothesised that stopping folic acid could be clinically useful as this would reduce treatment burden on patients and allow them to focus on adherence to more effective medicines.We reviewed the medical records of children receiving hydroxyurea for sickle cell disorders managed in our treatment centre. Children were selected for withdrawal from folic acid supplementation based on an absence of uncontrolled haemolysis; reticulocytes <200 x109/L and bilirubin <80µmol/L, and an absence of low serum folate or low red cell folate. Clinical and laboratory monitoring was performed every 4 weeks to establish whether any benefit or adverse effect could be identified. This included monitoring Hb, HbF, MCV, neutrophils, platelets, reticulocytes, serum folate and red cell folate levels.We withdrew folic acid supplementation from 30 children with sickle cell disorders (mean age 9.5 years (range 2-18)) and monitored clinical and laboratory parameters. At the time of this review, mean follow up time was 11.5 months (range 7-14).Baseline investigations showed that serum folate levels in 14 children were so high in comparison to normal reference ranges that they were unquantifiable by standard laboratory analysis at our centre. The mean serum folate level in the other 16 children was 39.5 nmol/L (reference range 3.4-38.5 nmol/L). Similarly, red cell folate levels in 5 children were above maximum quantifiable levels. The mean red cell folate level in the other 25 children was 1445 nmol/L (reference range 272-1948 nmol/L).On withdrawal of folic acid supplementation, all patients' serum folate and red cell folate levels returned to within the normal range. At the end of this observation period, mean serum folate level was 20.9 nmol/L and mean red cell folate level was 617.2 nmol/L, with no patients developing low serum folate or low red cell folate levels. No patients developed megaloblastic changes or any other clinical need to restart supplementation. Folic acid levels began to reduce immediately on withdrawal of supplementation and in most cases reached a plateau by 6 months. However, plateauing levels were not recorded in all patients and this is likely attributable to the shorter follow up time for some patients.All patients were managed as per our standard protocol of escalating hydroxyurea therapy to maximum tolerated dose. An increase in mean dose from 27.0 mg/kg/day to 30.3 mg/kg/day (p=0.0003) was recorded during the observation period. Other statistically significant changes in haematological parameters were: increased HbF (25.8% to 29.7%, p=0.0002 and increased MCV (91.2 to 94.7, p=0.026). No significant differences were recorded in haemoglobin, neutrophils, platelets or reticulocytes (statistical analysis was performed by paired T-test).Stopping folic acid supplementation has caused no observable adverse effects either clinically or in laboratory haematological parameters. The significant increases in HbF and MCV observed here can be explained by the significant increase in hydroxyurea dose during the observation period and are not likely to be an effect of stopping folic acid.Stopping folic acid is a minor change in patient management however, patients generally don't like taking medicines and stopping a medicine that is not required was seen as an improvement in quality of life. At the end of our observation period, laboratory parameters had improved and there was no evidence of any adverse effect of stopping folic acid supplementation in children with sickle cell disease.Dixit et al., 2016. Cochrane Review, CD011130Rabb et al., 1983. British Journal of Haematology 54(4):589-94 DisclosuresNo relevant conflicts of interest to declare.

Association between Human Parvovirus B19 (HP B19) and Acute Lymphoblastic Leukemia in Children.

Human Parvovirus B19 (HP B19), a single stranded DNA virus, is a global and common infectious pathogen in humans. Transmission of infection occurs via the respiratory route, through blood-derived products administered parenterally or through vertical transmission. The virus has tropism for rapidly dividing erythrocyte precursors. Usually infection by Human parvovirus B19 is mild & self limiting in healthy children while in children with hemoglobinopathy or hemolytic anemia the condition may be critical causing aplastic crisis due to short life span of red blood cells. Also, immunocompromized patients may develop serious complications like myocarditis, encephalitis & hepatitis. ALL, the most common cancer occurring in children, was recently described in association with HP B19. This study investigated this association.We compared between the presence of HP B19 DNA in CSF of 20 ALL cases at time of diagnosis before its disappearance by the developing immune system and its presence in CSF of 10 age and sex matched controls. The study showed the presence of HP B19 DNA in CSF of 4 ALL cases (20%) but in neither of the control group. It showed that cases of ALL positive for HP B19 DNA tend to be younger than ALL cases negative for HP B19 DNA. They were of common pre-B immunophenotype. They all had lower Hb, platelet and white blood cell count, this may be due to apoptotic effect of the NS1 protein of the HP B19 virus. It is important to state that the 4 ALL cases were screened for the state of their humoral immunity, the principle immune response against HP B19, and all of them had normal total IgG. Such finding may suggest that this association may surpass a mere opportunistic infection and that HP B19 may be incriminated in the pathogenesis of ALL. Further studies to prove the presence of HP B19 DNA in leukemia cells at the time of diagnosis as wellas further investigations are required on a larger scale to clarify the interaction between the HP B19 and the immune system in the hematological malignancies.