Hematological Markers Research Articles

The association of hematological inflammatory markers and psychological function in COVID-19 patients: A cross-sectional study.

Mental health disorders are linked to systemic inflammation. Due to high inflammation and mental health disorders in COVID-19 patients, we aimed to investigate the relationship between blood inflammatory markers such as red cell distribution width to platelet ratio (RPR), platelet-lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), white blood cell (WBC), and psychological function in COVID-19 patients. In the current cross-sectional study, neuro-psychological function, and a complete blood count (CBC) were measured on 120 COVID-19 patients aged >30 years from the Imam Reza Hospital in Mashhad, Iran. Our results showed that anxiety related to MCHC (mean ± SD: 32.71 ± 1.68, p < 0.05), WBC (mean ± SD: 12.23 ± 5.43, p < 0.05), and PLR (median (IQR): 28.72 (15.88-41.31), p < 0.05) significantly. In the stress subgroup, only RPR was associated with stress (p < 0.05). Linear regression between hematological parameters and psychological score indicated that RDW and PLR had a significantly positive association with depression (β = 0.086; p = 0.045 and β = 1.326; p = 0.016, respectively) and anxiety scores (β = 0.100; p = 0.038 and β = 1.356; p = 0.010, respectively). Moreover, a positive correlation was found between PLR and stress (β = 1.102; p = 0.012). This study showed a positive association between depression/anxiety/stress symptoms and levels of hematological inflammatory markers including PLR and RDW. The findings of this study provide novel insights into mental health and physiological markers, underscoring the potential influence of inflammation on mood disorders. Our findings offer exciting prospects for future research and may lead to innovative approaches in the management and treatment of depression, anxiety, and stress.

Role of biomarkers in prognostication of moderate and severe COVID-19 cases.

COVID-19 pandemic demanded upgrading of laboratory medicine to limit morbidity, disability and mortality from moderate and severe SARS-COV-2 infections. To assess among moderate and severe COVID-19 patients, C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, interleukin 6 (IL-6), lactate dehydrogenase (LDH), total and differential leucocyte count (TLC and DLC), neutrophil-to-lymphocyte ratio (NLR), absolute platelet count (APC), prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) to find their interdependence and role in prognosis. This open label analytical cross-sectional noninterventional study evaluated array of independent biochemical, haematological and coagulopathy markers, viz. CRP, PCT, ferritin, D-dimer, IL-6, LDH, TLC, DLC, NLR, absolute platelet count, PT, APTT and INR on consecutive 100 patients with diagnosis of moderate and severe COVID-19 from July to August 2021. In our study, on consecutive designated 100 cases (55 cases moderate and 45 cases severe), more severity were reported as the age progressed; gender difference was not noted. Among independent markers, CRP, PCT, ferritin, D-dimer, IL-6 and LDH had statistically significant relation in comparison with severity of the disease as Chi-square calculated value (P < 0.05). TLC, DLC and APC showed no significant relation in comparison with severity of the disease; NLR had highly significant relation. PT showed significant relation in comparison with severity, though APTT and INR did not show significant relation. Our research group felt that CRP, PCT, ferritin, D-dimer, IL-6, LDH and NLR should be in included in clinical practice guidelines to prognosticate COVID-19 cases. Furthermore, translational researches are needed at all levels of healthcare to improve validity for practices of primary care physicians.

A few hematological and biochemical markers of broilers breeders males ross-308 at various hesperidin and naringin concentrations

A few hematological and biochemical markers of broilers breeders males ross-308 at various hesperidin and naringin concentrations

The impact of Jussiaea repens aqueous extract on Hyperglycemic and Hematological markers in Diabetic male rat induced by Streptozotocin

In diabetic rats, the hypoglycemic potential of an aqueous extract of Jussiaea repens (50mg/100gm body weight) was examined. The herbal extract's impact on a number of hematological indicators was also studied. Eighteen albino rats, each contain 6 rats, were placed into three groups: vehicle control, diabetes control, and supplemented group. To develop diabetes, a single i.p injection of STZ (80mg/kg body weight) was given. Hematological markers include hemoglobin (Hb), red blood cell (RBC) count, white blood cell (WBC) count, packed cell volume (PCV), lymphocytes, and neutrophils, as well as blood glucose levels and HbA1c were assessed. STZ-induced diabetic rats fed the extract had lower fasting blood glucose levels, which was statistically significant (p&lt;0.05). The HbA1c level in the diabetic control group increased drastically, but the level in the extract-treated supplemented group reduced significantly. Hb, PCV, RBC, and WBC as well as their differentials, were significantly reduced in diabetic control rats, whereas the supplemented group recovered significantly.. These findings imply that the aqueous extract of Jussiaea repens has hypoglycemic action and overcomes the abnormalities in STZ-induced diabetic rats' blood parameters.

Iron deficiency and anemia in pediatric dilated cardiomyopathy are associated with clinical, biochemical, and hematological markers of severe disease and adverse outcomes

BackgroundThere is limited evidence regarding the prevalence and impact of iron deficiency (ID) in children with dilated cardiomyopathy (DCM). MethodsRetrospective single-centre review of all children between 2010-2020 with a diagnosis of DCM and complete iron studies. ID was defined as ≥ 2 of ferritin < 20 μg/L, iron < 9 μmol/L, transferrin > 3 g/L or transferrin saturation < 15%. Clinical and laboratory indices, and freedom from a composite adverse event (CAE) of mechanical circulatory support, heart transplant or death were compared between children with and without ID. ResultsOf 138 patients with DCM, 47 had available iron studies. Twenty-nine (62%) were iron deficient. Children with ID were more likely to be receiving inotropes (17, 59%, P =.005) or invasive/non-invasive ventilation (13, 45%, P =.016) than those who were iron replete. They had a higher incidence of anemia (22, 76%, P =.004) and higher NT-proBNP (1590pmol/L, IQR 456–3447, P =.001). Children with ID had significantly less freedom from the CAE at 1-year (54±10%), 2-years (45±10) and 5-years (37±11%) than those without (P =.011). Iron deficiency and anemia were the only significant predictors of the CAE on univariate Cox regression. ConclusionsIron deficiency is highly prevalent in children with DCM. Iron studies are under-measured in clinical practice, but ID is associated with severe heart failure, and an increased risk of the CAE. The need for iron replacement therapy should be considered in children who present in heart failure with DCM.

Electroconvulsive therapy improves hematological inflammatory markers in bipolar disorder.

Immune dysfunction and inflammation participate in the pathophysiology of bipolar disorder (BD). Abnormal levels of inflammatory markers, namely, red cell distribution width (RDW) and platelet distribution width (PDW), were detected in BD. Electroconvulsive therapy (ECT) for various mental disorders including BD was linked to changes in these inflammatory mediators. Hence, we aimed to assess the impact of ECT on PDW and RDW in patients with BD. Seventy-two patients aged ≥ 16 were enrolled in the current prospective cohort study over 6 months, diagnosed as BD based on DSM-IV and indicated for ECT and complete blood count (CBC) drawn pre-ECT and after four ECT sessions. By the end of the ECT sessions, we noticed a significant elevation in PDW with lowering in RDW levels. However, no significant differences were detected before and after ECT regarding platelet (PLTs) count, mean platelet volume (MPV), and Plateletcrit (PCT). ECT seems to improve the CBC-derived inflammatory markers (RDW and PDW) subsequently, improving the underlying inflammatory process in BD without disturbing PLT homeostasis which support its anti-inflammatory role in BD.

The potential synergistic action of quercetin and/or Pediococcus acidilactici on Nile tilapia, Oreochromis niloticus performance

An 84-day experimental trial was conducted to investigate the effects of dietary quercetin, Pediococcus acidilactici or combined on growth performance, intestinal digestive enzymes, feed utilization, bacterial counts, intestinal histo-morphometric indices, hemato-biochemical indices, and antioxidant responses in Nile tilapia, Oreochromis niloticus. Four isonitrogenous (30.34 g kg−1 of crude protein) and isocaloric (19.21 MJ kg−1 gross energy) diets were formulated from practical ingredients. The first diet was the control diet. The other three formulated diets were supplemented with 5 g quercetin (quer) kg−1 diet or P. acidilacticiat 2 × 109 CFU kg− 1 (probiotic; pro), and their mixture 5 g quercetin kg−1 + 2 × 109P. acidilactici (CFU kg− 1) (pro-quer). A total number of 300 healthy fingerlings (Initial average weight 4.51 ± 0.01 g) were randomly allocated into four groups (25 fish for each group in triplicates). The results showed that the best values of growth, feed efficiency, and feed conversion ratio (FCR) were recorded in fish fed diet containing pro-quer. The activity of endogenous enzymes including; amylase, lipase, trypsin, and chymotrypsin was substantially boosted (P < 0.05) by supplemental diets with quercetin, probiotic, and pro-quer. Furthermore, fish fed diet supplemented with pro-quer had greater villi width, villi height, goblet cells, absorption area, muscularis mucosa, and muscularis. The highest total intestinal and gut bacterial counts were detected in fish fed diet supplemental with probiotic. Diets supplemented with quercetin, probiotic, and pro-quer substantially improved hematological markers including hematocrit (Htc), hemoglobin (Hb), red blood cell (RBC), and white blood cell (WBC) counts. The fish given a pro-quer diet had the lowest significant (P < 0.05) ALT value, whereas that fed quercetin had the lowest AST value. Serum total protein, globulin, and albumin levels were higher (P < 0.05) in fish fed diets containing quercetin, probiotic, and pro-quer compared to the control diet, with the greatest levels found in those fed diet supplemented with quercetin. However, supplementation of quercetin, probiotic, and pro-quer, lowered the levels of cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride. The supplemental diets with quercetin, probiotic, and pro-quer improved the activities of catalase (CAT), glutathione peroxidase (Gpx), superoxide dismutase (SOD), and total antioxidant capacity (TAC) compared with the control diet. In conclusion, the synergetic effect between quercetin and probiotic ameliorated the growth, feed efficiency, intestinal digestive enzymes, intestinal histological morphometric, hemato-biochemical indices, and antioxidant responses of Nile tilapia.

Curative efficacy of polyphenols against acrylamide induced toxicity and analysis of acrylamide in Indian food by LCMS method

Acrylamide (AA) is formed during the processing of food at high temperature. It is an alarming need to quantify AA content in food as it is reported to be neurotoxic and carcinogenic. Aim of this study was to evaluate the concentration of AA in different foodstuffs of India's Gwalior region, using the LC-MS technique. A total of 100 food samples were collected from the local market. The curative role of polyphenolic compounds (kaempferol, linolic acid, Caffeic Acid, and Hesperidin) at the dose of 20 mg/kg was also evaluated against acrylamide-induced toxicity in rats by performing hematological, LFTs and KFTs marker. By calculating chromatographic peaks, out of 100 samples, 77 showed positive AA levels ranging from 0.08 µg/kg–2600 µg/kg. The highest concentration of AA was found in aloo lachche (2600 µg/kg) followed by aloo bhujia (1401 µg/kg). Our experimental results revealed that polyphenols significantly recovered all the altered parameters caused by AA toxicity toward normal, which may be due to their antioxidant capacity.

Hematological and biochemical markers influencing breast cancer risk and mortality: Prospective cohort study in the UK Biobank by multi-state models

BackgroundBreast cancer is the most common cancer and the leading cause of cancer-related death among women. However, evidence concerning hematological and biochemical markers influencing the natural history of breast cancer from in situ breast cancer to mortality is limited. MethodsIn the UK Biobank cohort, 260,079 women were enrolled during 2006–2010 and were followed up until 2019 to test the 59 hematological and biochemical markers associated with breast cancer risk and mortality. The strengths of these associations were evaluated using the multivariable Cox regression models. To understand the natural history of breast cancer, multi-state survival models were further applied to examine the effects of biomarkers on transitions between different states of breast cancer. ResultsEleven biomarkers were found to be significantly associated with the risk of invasive breast cancer, including mainly inflammatory-related biomarkers and endogenous hormones, while serum testosterone was also associated with the risk of in-situ breast cancer. Among them, C-reactive protein (CRP) was more likely to be associated with invasive breast cancer and its transition to death from breast cancer (HR for the highest quartile = 1.46, 95 % CI = 1.07–1.97), while testosterone and insulin-like growth factor-1 (IGF-1) were more likely to impact the early state of breast cancer development (Testosterone: HR for the highest quartile = 1.31, 95 % CI = 1.12–1.53; IGF-1: HR for the highest quartile = 1.17, 95 % CI = 1.00–1.38). ConclusionSerum CRP, testosterone, and IGF-1 have different impacts on the transitions of different breast cancer states, confirming the role of chronic inflammation and endogenous hormones in breast cancer progression. This study further highlights the need of closer surveillance for these biomarkers during the breast cancer development course.

Evaluation of acute, subacute, and subchronic toxicity of a hepatoprotective herbal formulation

BackgroundThe possible toxicity of natural products must be tested before being used in the market. The present work aimed to evaluate acute, subacute, and subchronic toxicity of an herbal formulation containing Anethum graveolens, Cynara scolymus, Citrus aurantium, Portulaca oleracea, and Silybum marianum. Material and methodsAcute toxicity (2000 mg/kg, single dose) and sub-acute toxicity (600 and 1200 mg/kg/day, 4 weeks) tests were performed on female and male rats according to OECD 423 and OECD 407 guidelines, respectively. In the subchronic study (12 weeks), the animals were divided into three groups (6 females and 6 males per group): control, low-dose group (food supplemented with 300 mg/kg of the herbal product), and high-dose group (600 mg/kg). ResultsThe herbal product at a single dose of 2000 mg/kg did not induce mortality for 14 days. In the sub-acute study, administration of the product for 28 days at 1200 mg/kg/day had no effect on survival, appetite (water and food consumption), body weight, serum biochemical parameters (BUN, creatinine, AST, ALT, ALP, bilirubin, albumin), histology of vital organs (liver, kidney, heart, brain), and hematological markers related to erythrocyte, platelet, and leukocyte. Similarly, in the subchronic study, the product did not induce mortality, change in histology of the vital organs, or alteration in hematological or biochemical parameters (except for an increase in ALP in female rats received 600 mg/kg). ConclusionThe formulated product shows no signs of toxicity in rats up to 2000 mg/kg, 1200 mg/kg, and 600 mg/kg in acute, subacute, and subchronic phases, respectively. It is suggested to monitor ALP levels in females in case of long-term use of the product.

PSVI-1 Elucidating the Effects of the CXCL12/CXCR4 Axis Through Hematological Changes in Sheep During Gestation

Abstract The placenta, an organ that develops during pregnancy, is essential for transporting nutrients and oxygen to the developing offspring. Formation of the placenta is characterized by many physiological and hematological changes necessary for a healthy gestation. Improper placentation causes placental insufficiency which increases fetal mortality and poor postnatal health and performance. Causes of placental insufficiency are poorly understood, however evidence indicates immune factors including the chemokine ligand 12 (CXCL12) and its receptor (CXCR4) regulate several processes central to placentation and white blood cells (WBC) have essential roles by promoting trophoblast invasion and supporting artery remodeling. We previously demonstrated suppressing CXCL12/CXCR4 signaling at the fetal-maternal interface during implantation diminishes placental vascularization, reduces trophoblast invasion, and creates an excessively inflammatory placental environment. Building on these studies, we hypothesized the negative impacts early in gestation would result in compromised placental development and altered hematological parameters during gestation. Identifying key hematological changes or inflammatory markers in a complete blood count analysis during pregnancy might provide diagnostic clues to placental insufficiency at early stages of pregnancy. Our objective was to determine if disrupting the CXCL12/CXCR4 axis during implantation results in an altered hematological profile or serum progesterone (P4) concentrations. Using an in-vivo sheep model osmotic pumps were surgically installed to deliver treatments into the uterine lumen on day 12 of gestation. Pumps delivered either CXCR4 inhibitor (AMD3100) at (1X, 1.5X, or 3X dose), CXCL12 at (low or high dose), or PBS (control) into the uterus over the course of 14 days. Blood samples were collected via jugular venipuncture daily from days 11 to 16 of gestation, every two days from days 18 to 30, and weekly from day 35 to 135 and analyzed within 2 h of collection for a complete blood count using the Abaxis VetScan HM5. Serum was also collected and P4 concentrations were quantified by radioimmunoassay. Manipulating the CXCL12/CXCR4 axis during early gestation did not affect (P = 0.98) systemic circulating progesterone values during days tested, but neutrophils, lymphocytes, WBCs, and platelets increased indicated systemic inflammation. Of the hematological parameters tested, WBC counts were increased (P &amp;lt; 0.05) in the 3X AMD3100 treatment group and neutrophils and lymphocytes tended (P &amp;lt; 0.1) to increase compared with control. Our results reveal that suppressing CXCL12/CXCR4 signaling during early gestation creates an inflammatory response reflected in circulation. A greater understanding of hematological changes and endometrial interactions involved in placentation in sheep is necessary to elucidate the causes of placental insufficiency and recurrent pregnancy loss. Future research will investigate if circulating markers indicative of placental dysfunction exist which may lead to methods to improve fertility, pregnancy outcomes, and fetal health.

Association between the peripheral neutrophil-to-lymphocyte ratio and metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes.

Metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes frequently co-occur, imposing a tremendous medical burden. A convenient and effective MASLD indicator will be beneficial to the early diagnosis of disease. In the clinical laboratory, the neutrophil-to-lymphocyte ratio (NLR) is a readily accessible hematological marker. This study designed to determine the relation between the NLR and MASLD in type 2 diabetes patients. Data from 1,151 type 2 diabetes inpatients without infections, malignancy or hematological diseases who were recruited from 2016 through 2022 were analyzed in the retrospective study. The patients were stratified into NLR tertiles (total population: high NLR level > 2.18; middle NLR level: 1.58-2.18; low NLR level < 1.58), with additional subgroup stratification by sex (men: high NLR level > 2.21; middle NLR level: 1.60-2.21; and low NLR level < 1.60; women: high NLR level > 2.12; middle NLR level: 1.53-2.12; and low NLR level < 1.53). After adjusting for confounders (age, sex, weight, Glu, ALT and TG) associated with MASLD, the odds ratio (OR) and the corresponding 95% confidence interval (CI) of the NLR were obtained by using a binary logistic regression analysis to verify the correlation between the NLR and MASLD. Compared to non-MASLD patients, MASLD patients had higher weight, blood glucose, insulin and C-peptide, worse liver function (higher ALT and GGT), lower HDL (all p < 0.05), and lower NLR (p < 0.001). The prevalence of MASLD was 43.75% (high NLR level), 55.21% (middle NLR level) and 52.22% (low NLR level) (p < 0.05). Compared to those of the high NLR level, the adjusted ORs and 95% CIs of the middle and low NLR levels were 1.624 (95% CI: 1.141-2.311) and 1.456 (95% CI: 1.025-2.068), for all subjects, while they were 1.640 (95% CI: 1.000-2.689) and 1.685 (95% CI: 1.026-2.766), for men. A low NLR is associated with a greater risk of MASLD.

Efficacy and Safety of Single Agent Proximal Complement Inhibitors in Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients with Residual Anemia Despite of Adequate Terminal Complement Inhibitor Use

Background: Introduction of C5 inhibitors is a major advancement in the treatment of Paroxysmal Nocturnal Hemoglobinuria (PNH) patients. First Eculizumab and then Ravulizumab significantly improved anemia by controlling intravascular hemolysis (IVH), reduced thrombosis risk, improved quality of life and prolonged survival. However, a significant proportion of PNH patients remain anemic with transfusion dependence despite maximal C5 inhibition due to C3 mediated residual extravascular hemolysis (EVH). Recently two randomized, open label, controlled trials with proximal complement inhibitors were studied in this patient population comparing against C5 inhibitors as single agents with excellent results. Here we compare efficacy and safety data of proximal complement inhibitors pegcetacoplan (C3 inhibitor), Iptacopan (factor b inhibitor) based on published or presented data. Methods: We compared the efficacy and safety data of randomized portion of PEGASUS and APPLY-PNH trials. PEGASUS trial is a phase 3, randomized, open label, active-comparator controlled trial with Pegcetacoplan (a pegylated pentadecapeptide that targets C3) compared efficacy and safety against eculizumab in PNH patients with Hb &amp;lt;10.5 despite of treatment with Eculizumab (Hillerman, et al NEJM 2021;384). Primary end point of the study was mean change in Hb level from baseline to week 16. APPLY-PNH is an open label randomized, multicenter phase 3 trial compared Iptacopan 200 mg BID (oral factor b inhibitor) monotherapy with standard of care C5 inhibition therapy. (Regis P. de Latour et al. Blood (2022) 140 (Suppl 2): LBA-2). Primary end points of the trial were Hematological response defined as an increase in Hb of ≥ 2 g/dL from baseline and Hb ≥ 12 g/dL in absence of transfusions. Secondary end points included number of clinical and hematological markers of hemolysis and safety. Results: Summarized in table 1. PEGASUS trial included 80 patients with 41 in pegcetacoplan arm and 39 in Eculizumab arm. APPLY-PNH included 97 patients with 62 in Iptacopan arm compared to 35 in standard of care anti C5 therapy. Majority of baseline characteristics were similar between two studies. Mean age in both studies was around 50 years and close to 2/3rd of patients in each study were females. Median duration of prior C5 therapy was between 3-4 years in both studies. More than half of patients in both studies required PRBC transfusions in preceding months prior to enrollment. Baseline mean Hb was between 8-9 g/dL, LDH between 250-300 U/L, mean absolute retic count (ARC) 190-200x109/L. Both studies showed superiority in change from baseline Hb with +2.69 g/dL in PEGASUS trial with all available data regardless of transfusion events and +3.63 in APPLY-PNH trial. Both studies showed either noninferiority or superiority in freedom from transfusions and change in ARC. Interestingly, LDH change was not significant in both studies. Change from baseline fatigue FACIT-score was numerically better but not tested in PEGASUS trial and was superior in APPLY-PNH. No major vascular events or serious infections by encapsulated bacteria were reported in either study. Breakthrough hemolysis was reported in 4 out of 40 patients in PEGASUS trial that led to treatment discontinuation in 3 patients and 2 out of 62 patients in APPLY-PNH trial, however none of them required treatment discontinuation. Conclusions: PEGASUS and APPLY-PNH trials showed that in patients with persistent anemia despite C5 inhibitor therapy, proximal complement inhibition with either pegcetacoplan (C3 inhibitor) or Iptacopan (factor b inhibitor) as a single agent showed significant improvement in Hemoglobin with higher rate of transfusion independence with control of extra vascular hemolysis while maintaining intravascular hemolysis control with no serious infections. These studies represent another major advancement in the management of PNH patients. Long term follow up is needed regarding safety and to identify better ways to manage breakthrough hemolysis in patients on proximal complement inhibitors.

Longitudinal Characterization of Hemodynamic Changes with Multimodal Optical Techniques in Patients with Sickle Cell Disease Treated with Mitapivat

The physiological impacts of sickle cell disease (SCD) are widespread and severe if left untreated. Sickled RBCs initiate vaso-occlusion (VOC) and have altered biomechanical properties that negatively affect blood rheology and microvascular hemodynamics in patients with SCD. Therapeutics can target different mechanistic pathways including reduction of hemoglobin S (HbS) polymerization, oxidative stress, or inflammation. There is an unmet need for non-invasive, point-of-care technologies that characterize the microvascular hemodynamics in SCD which could potentially broaden understanding of the underlying pathophysiology and supplement a clinician's ability to monitor therapeutic changes. Current clinical approaches can be time- and resource- intensive which limit their accessibility. Near-infrared spectroscopy (NIRS) is a non-invasive, optical technique that quantifies microvascular hemodynamics including hemoglobin (Hb) concentration, tissue oxygen saturation (StO 2), and blood flow (Cerussi et al, 2005). We evaluate the sensitivity of NIRS technologies to hemodynamic changes in patients with SCD undergoing treatment with mitapivat, an investigational oral allosteric activator of pyruvate kinase (PK), and compare the optical changes to changes in standard hematology markers with regard to the initial response and consistency of the response over time. Fifteen patientswith HbSSwere enrolled in a study (ClinicalTrials.gov, NCT04610866) evaluating the long-term safety and tolerability of mitapivat in patients with SCD. We performed an optical hemodynamic assessment for each patient for a total of eight study visits over the span of a year including at baseline prior to drug initiation. NIRS probes were affixed to the forearm and forehead to collect hemodynamic information characteristic of brain and skeletal muscle while performing a brachial cuff occlusion challenge. We quantified concentration of oxy- and deoxy- Hb as well as StO 2 during the resting baseline prior to the occlusion. Additionally, we analyzed the post-occlusion reactive hyperemic response to assess vascular reactivity. Analysis was focused on quantifying the degree of change due to mitapivat treatment as well as the consistency of the response over the course of a year. Optical metrics were first compared against changes in Hb (Quang et, 2022) and then evaluated for consistency throughout the rest of the study period. Nine out of 15 patients were assessed as baseline NIRS data were not available for six patients.We calculated optical hemodynamic metrics for all 72 measurement visits; two visits were excluded due to poor NIRS data quality. Figure 1A shows a typical measurement setup with NIRS probes acquiring simultaneous measurements from the forehead and forearm. Figure 1B compares the mean Hb level, mean forehead StO 2, and mean forearm StO 2 across the first year of treatment. Over the first six months, we observed an increase in forehead StO 2 from 56% to 60% and forearm StO 2 from 59% to 63%; blood Hb levels exhibited a similar increase going from 8.5 g/dL to 9.8 g/dL; this increase was sustained over the second six months for all three parameters. Average forehead StO 2 remained +3.6% above baseline while forearm StO 2 remained +1.7% above baseline at the end of a year. NIRS can non-invasively provide objective measures of tissue composition, metabolism and vascular reactivity and can be performed in a simple manner with a series of simple perturbations.In this limited dataset, we have demonstrated that NIRS appears to reflect changes in Hb related to mitapivat both in response to an acute change and over an extended period. Furthermore, we observed that on average, the NIRS responses were consistently elevated throughout the course of the year, mirroring what was observed in the blood Hb levels. Hemodynamic changes appear to be more easily observed in the brain rather than the skeletal muscle. Our data suggest that NIRS could be an adjunct for non-invasive hemodynamic monitoring in patients with SCD undergoing treatment.

Evaluation of the effect of soaked false yam (Icacina oliviformis) tuber meal on the haematological indices and serum biochemistry of rabbits

BackgroundThe exploitations of non-conventional feeds for livestock have sparked great interest due to human-animal competition for conventional feedstuffs. The majority of animal feedstuffs are formulated with grains as the major ingredient, resulting in tautness and an increase in the costs of conventional feeds. This practice has underscored the necessity for an alternatively cheap and sustainable non-conventional feedstuff to salvage the feeding restraint to animal production. With this, the present study aimed at evaluating the effect of soaked false yam tuber meal (SFYTM) on the haematological indices and serum biochemical profile of weaner rabbits. MethodsSixteen local weaned rabbits of diversified breeds and sexes were randomly apportioned to dietary treatments containing 0, 10, 15, and 20 % of soaked false yam tuber in replacement for maize in a maize-fishmeal-based diet. Following feeding trials, blood samples from the rabbits were taken and analyzed using haematology and chemistry analyzers. ResultsThe haematological assay revealed significant differences (P < 0.05) among treatments for red blood cells (RBCs), total white blood cells (TWBCs), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and monocytes. For haemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), platelet, lymphocytes, neutrophils, esoniphiles, and basophils, no significant differences (P > 0.05) were achieved. With the serum biochemical tests, significantly higher values were obtained for alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and sodium relative to the control. Despite some of the evaluated parameters having relatively high values, they tumbled within the normal range of values for a healthy weaned rabbit. ConclusionFalse yam tuber can therefore be exploited as a substitute for maize in rabbits’ diets without detrimental effects on the haematological and biochemical markers of the farm animals.

Analysis of Hematological Indices in Patients of Systemic Lupus Erythematous and Its Correlation with SLEDAI-2K.

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which is characterized by chronic multisystem inflammation and end-organ damage. In recent times there has been a need for new hematological markers to assess disease activity in SLE patients specifically, which can be easily available like eosinophil, basophil, neutrophil, monocytes, and platelet to lymphocyte ratios (ELR, BLR, NLR, MLR, and PLR, respectively). Materials and methods: The present investigation determines the use of a different peripheral hematological marker to assess SLE activity in 106 patients attended for medical care at Sawai Mansingh (SMS) Medical College and attached hospital, Jaipur. SLE disease activity index 2000 (SLEDAI-2K) was used to assess the disease activity in all patients. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed in each subject. The ratio of various hematological indices, like NLR, BLR, ELR, MLR, PLR, etc., analyzed and correlated with CRP, ESR, and SLEDAI-2K. Results: The present study revealed that the SLEDAI-2K score showed a significant positive correlation with ELR and MLR (p < 0.005). CRP showed a significant positive correlation with PLR (p < 0.005). ESR showed a significant positive correlation with ELR, MLR, PLR, and NLR (p < 0.005). Conclusion: The final results demonstrate that in SLE patients, the ratio of hematological indices like ELR, MLR, and PLR can be employed as disease activity markers. How to cite this article: Meena VP, Meena PD, Chejara RS, et al. Analysis of Hematological Indices in Patients of Systemic Lupus Erythematous and Its Correlation with SLEDAI-2K. J Assoc Physicians India 2023;71(11):40-42.

Acute and Sub-Acute Toxicity Evaluation of the Crude Methanolic Extract of Justicia schimperiana Leaf in Wistar Albino Rats.

This study evaluates the acute and sub-acute toxicity of 80% methanolic extracts of the leaves of Justicia schimperiana in Wistar albino rat models. Dried powdered leaves of Justicia schimperiana were macerated in 80% methanol. The experiment was conducted in accordance with the Organization for Economic Co-operation and Development guideline 423 for acute and 407 for sub-acute toxicity testing. A single dose of 5000 mg/kg extract was orally administered to three female rats for the acute toxicity study. The plant extract was administered orally for 28 days in daily dosages of 250, 500, and 1000 mg/kg for the sub-acute study. Animals in a control group were given distilled water. A total of 40 rats (5 rats/group/sex) were used for the sub-acute toxicity testing. Daily food intake and weekly body weight measurements were done. The rats were sacrificed at the end of the 28-day treatment period for hematological, biochemical, and histopathological tests. One-way analysis of variance and Kruskal-Wallis tests were employed for the analysis. The single-dose oral administration of the plant resulted in no deaths or serious morbidity. The median lethal dose was >5000 mg/kg. The 28-day oral treatment of the plant extract had no significant effect on general behavior, food intake, organ weight, biochemical parameters, or the majority of the hematological markers, with the exception of the decrease in hemoglobin and hematocrit in the 1000 mg/kg extract-treated groups compared to the controls. Both sexes experienced significant weight increases at all dosage levels. With the exception of minor alterations in a few of the organs, no significant histological change was identified. It is concluded that the single-dose and repeated-dose 28-day oral administration of the methanolic leaf extract of Justicia schimperiana is relatively safe.

Transforaminal Full-Endoscopic Lumbar Discectomy for Lumbar Pyogenic Discitis: A Review

Pyogenic discitis can cause significant back pain, neurological complications, and spinal deformities. An early and accurate diagnosis of pyogenic discitis is crucial for its effective management. Magnetic resonance imaging is the gold standard for the diagnosis of pyogenic discitis. Hematologic markers such as white blood cell count, erythrocyte sedimentation rate, and C-reactive protein level are also helpful in monitoring disease progression. Furthermore, blood culture is essential for identifying the causative bacteria and selecting the antibiotic to be used. Biopsies are useful for identifying the causative bacteria when blood cultures are negative or when antibiotics are not sufficiently effective. While open biopsy or computed tomography-guided biopsy has conventionally been used for this purpose, recently, transforaminal full-endoscopic biopsies have been used to detect the causative bacteria in pyogenic discitis. Endoscopy can be used to obtain sufficient intervertebral disc samples with direct visualization, which increases the detection rate of causative bacteria and has been reported to be effective in relieving back pain through decompression for pyogenic disc space. However, the effectiveness of endoscopic surgery might be limited in cases of advanced infection or extensive bone destruction. In such situations, open surgery with anterior reconstruction using minimally invasive techniques may be preferred. Although it has its limits, transforaminal full-endoscopic discectomy has emerged as a standard method for identifying the causative bacteria in pyogenic discitis. It also has a high therapeutic effect.

Vitamin D and Hematological Indicators of Inflammation in Prediabetes

Objectives: Prediabetes is characterized by the presence of inflammation. Hematological parameters provide the advantageous qualities of being cost-effective and readily reproducible, rendering them highly helpful for the purpose of disease surveillance. The impact of vitamin D on inflammatory mediators and its role in the progression from prediabetes to type 2 diabetes has been seen. This study aims to investigate hematological markers, glycemic management, and vitamin D status among individuals with prediabetes. Methods: A retrospective investigation was performed on a cohort of 270 persons with prediabetes (5.7-6.4% glycated hemoglobin levels) and 299 participants with normal blood glucose levels. In order to conduct a comparison of hematological indicators between two groups, statistical analyses including chi square analysis and the t test were employed. The analysis of variance (ANOVA) statistical method was employed to analyze the components within three distinct categories of Vitamin D levels: acceptable (more than 75 nmol/L), inadequate (ranging from 50 to 74.9 nmol/L), and deficient (50 nmol/L). The odds ratio for prediabetes was obtained through the utilization of regression analysis. Results: The study observed a statistically significant decrease in vitamin D levels among individuals with prediabetes (mean 57.91 ± 20.83, p = 0.05). The group of individuals with prediabetes exhibited significantly higher values for the neutrophil lymphocyte ratio (2.10 ± 0.85; p = 0.05), platelet lymphocyte ratio (137.70 ± 43.70; p = 0.05), mean platelet volume (8.55 ± 3.00; p = 0.001), and red cell distribution width (12.65 ± 1.31; p = 0.05). The present study observed a statistically significant positive correlation between declining levels of vitamin D and increasing trends in the neutrophil lymphocyte ratio, platelet lymphocyte ratio, and red cell distribution width in individuals with prediabetes. The study revealed that the mean platelet volume had a noteworthy association with the development of prediabetes. Conclusions: The neutrophil lymphocyte ratio, platelet lymphocyte ratio, red cell distribution width, and mean platelet volume are emerging inflammatory markers that can be employed for monitoring purposes in patients with prediabetes. However, it is important to note that these indicators should be utilized in combination with an assessment of Vitamin D status.

Evaluating the protective effect of metformin against diclofenac-induced oxidative stress and hepatic damage: In vitro and in vivo studies

Diclofenac (DIC) is one of the most commonly prescribed non-steroidal anti-inflammatory drugs and has been shown to cause oxidative stress and liver injury. The current study investigated protective effects of metformin against DIC-induced hepatic toxicity in both in vitro and in vivo models. For the in vitro study, HepG2 cells were exposed to DIC in the presence or absence of metformin. The effect of metformin on cell viability was evaluated by MTT assay. Oxidative stress parameters (malondialdehyde (MDA), total thiol molecules (TTM), and total antioxidant capacity (TAC)) were assessed. For the in vivo study, thirty-six male Wistar rats were randomly divided into 6 groups. These groups were normal saline, metformin (200 mg/kg), DIC (50 mg/kg/day), DIC + metformin (50, 100, and 200 mg/kg/day). Histopathological studies and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), albumin, direct and total bilirubin were measured. Also, oxidative stress parameters were assessed in liver tissue. Furthermore, expression of glutathione peroxidase (GPX)-1, −3, and −4, catalase (CAT), superoxide dismutase (SOD)-1, and −3 was examined using the real-time PCR method in hepatic tissue. In the in vitro study, metformin significantly prevented DIC-induced loss in cell viability in HepG2 cells. Metformin markedly reduced DIC-induced elevation of MDA levels and increased the TAC and TTM levels. In the in vivo study, metformin significantly prevented DIC-induced changes in hematological and histological markers. Administration of metformin significantly improved oxidative stress parameters in liver tissue. In addition, metformin increased the expression of antioxidant enzymes. Our results suggest that metformin exerts a significant protective effect against DIC-induced hepatic toxicity.