Hematological Pattern Research Articles

Acute Myeloid Leukemia among Patients attending Sana’a Hospitals, Yemen: Prevalence, Subtypes and Hematological Patterns

Objectives: Acute myeloid leukemia (AML) is malignant disorder of cells of myeloid lineage in the bone marrow due to chromosomal abnormalities, leading to accumulation of myeloblasts in the bone marrow and infiltration to peripheral tissues. The aim of this study was to determine the prevalence, subtypes and hematological patterns of AML among patients attending Sana’a hospitals, Yemen. Materials and methods: This cross-sectional study was carried out on total 257 patients with hematological malignancies (HMs) during the period from November 1, 2023 to March 31, 2024. Among HMs, there were 79 patients diagnosed with AML by complete blood count (CBC), by Giemsa stained blood/BM films, and by immunophenotyping using flow cytometry. Data was analyzed using SPSS-26. Results: Among 257 patients with HMs, AML was found in 79 patients with prevalence of 30.7%. AML patients included 53 (67.1%) males and 26 (32.9%) females., with M:F ratio of 2:1 and aged between 4 and 80 years, FAB-M2 was the most common subtype of AML in 30 (37.97%) of patients; among them, there were 19 (24.05%) males and 11 (13.92%) females, the M:F ratio is 1.7:1. FAB-M2 was followed by M1 (26.58), M5 (17.2), M3 (7.59), M4 (5.06), M0 (3.8) and M7 (1.26). The hematological patterns included decreased Hb, increased WBC and decreased platelets in 97.5%, 82.3% and 96.2% of patients, respectively. Conclusion: Leukemia was the most prevalent type among hematological malignancies. The prevalence of AML was high and represent the second leukemia type. AML-M2 was the common subtype of AML.

Clinico-Hematological Patterns of Patients Presenting With Erythrocytosis

Objective: To assess the frequency of erythrocytosis and compare the clinical features and haematological parameters in patients presenting with primary and secondary erythrocytosis in the Pakistani population. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi Pakistan, from May 2020 to May 2021. Methodology: Eighty-three subjects presenting with marked erythrocytosis (Hb-17 g/dl or more, HCT – 50% or more) were included in the study, while those admitted with conditions leading to spurious polycythaemia or patients on diuretics were excluded. Polycythaemia vera was diagnosed as per revised WHO criteria 2016. Results: Only 23 subjects (27.71%) fulfilled the diagnostic criteria for Polycythaemia vera, while 60 subjects (72.29%) had secondary erythrocytosis. Significant differences were observed in haematological patterns between Polycythaemia vera and Secondary erythrocytosis patients. Of the 23 Polycythaemia vera subjects, 20(86.9%) were males and only 3(13.1%) were females, whereas 35(58.3%) out of 60 subjects with secondary erythrocytosis were males and 25(41.6%) were females (p=0.01). Males showed a higher frequency of Polycythaemia vera and, hence, of Janus Kinase2 positivity than females (Odds ratio=0.23, p=0.02). Conclusion: Polycythemia vera is less common than secondary erythrocytosis in the local population. Males showed a higher frequency of Polycythemia vera and, hence, of Janus Kinase2 positivity than females.

Biochemical and Hematological Patterns of Hospitalized COVID-19 Patients in Mongolia

Objectives: The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. This study aimed to analyze how the clinical and laboratory characteristics reflect the disease process and progression of COVID-19 cases in hospitalized patients of Mongolia, which could be informative in managing patients with COVID-19. Methods: A cross-sectional study was conducted on the prescription patterns of drugs given to hospitalized patients diagnosed with COVID-19. A total of 1012 participants were recruited in the study. These were identified from the reported positive cases by polymerase chain reaction or antigen reactivity performed in Ulaanbaatar. Result: A total of 1096 patients participated in this study. The mean age was 51.86 ± 16.98 for male patients and 52.23 ± 16.4 for female patients. It has been revealed that there are statistically significant differences between male and female patients. RBC was 4.56 ± 0.79 M/ UL and 5.08 ± 1.36 M/UL, men and women respectively. The levels of C-reactive protein (CRP) in female COVID-19 patients were significantly higher (46.75 ± 72.83 mg/dL) compared to male patients (33.94 ± 47.96 mg/dL). The platelet count (PLT) was 245.32 ± 77.71 for male patients, while there was a significant reduction in PLT count in female patients (229.30 ± 71.59). Conclusions: Patients with COVID-19 in Mongolia appeared to remain in the hospital for 6.86 ± 2.43 days, shorter than in other countries. Hematological analysis showed that female patients had elevated C-reactive protein levels and decreased PLT count.

Inquérito epidemiológico e estudo de casos da brucelose canina por Brucella abortus

The objective of this research was to identify brucellosis by Brucella abortus and the possible risk factors associated with the transmission of the infection in dogs in the urban area of the municipality of Viçosa-AL, as well as to alert health authorities about the risk of this potential zoonosis, create a booklet to alert the population about the risks of the disease and the possibility of creating a test protocol in clinical care at the Veterinary Hospital of the Federal University of Alagoas. A study was carried out in the city of Viçosa-AL to investigate the presence of B. abortus in 30 adult male dogs. The animals that showed symptoms suggestive of reproductive disease were referred for evaluation of the hematological pattern and clinical and surgical treatment. Parallel to the blood collection, a questionnaire was applied to the owners of these dogs. Buffered acid antigen (AAT) techniques were used as a screening test and 2-Mercaptoethanol (2-ME) as a confirmatory test for AAT positives with symptoms of brucellosis. The study aimed to analyze the number of positive dogs, the clinical and anatomopathological changes and the risk factors for the occurrence of brucellosis in dogs in the municipality of Viçosa-AL. As dogs are a means of transmission for humans, health authorities must pay special attention to this disease, including the control of dogs in the Program for Control and Eradication of Brucellosis of the Ministry of Agriculture. In addition to intensifying control of vaccination and diagnosis in cattle.

Pattern recognition of hematological profiles of tumors of the digestive tract: an exploratory study.

In this study, we aimed to apply laboratory blood analysis to identify the hematological (based on hemoglobin concentration, erythrocytes, hematocrit, and RDW count) profiles associated with the most prevalent forms of digestive tract malignancies. Furthermore, we aimed to evaluate how these profiles contributed to distinguishing these tumors at diagnosis. We collected data from the date of ICD-10 diagnostic coding for C15 esophagus, C16 stomach, C18 colon, and C19 rectum tumors of 184 individuals. The statistical analysis and data visualization approaches, notably the heat map and principal component analysis (PCA), allowed for creating a summary hematological profile and identifying the most associated parameters for each pathologic state. Univariate and multivariate data modeling and ROC analysis were performed in both SPSS and Python. Our data reveal unique patterns based on tumor development anatomical location, clustering the C18 colon and C19 rectum from the C15 esophagus and C16 stomach. We found a significant difference between C16 stomach carcinoma and the other tumors, which substantially correlated with raised RDW in conjunction with low hemoglobin concentration, erythrocytes, and hematocrit counts. In contrast, C18 colon carcinoma had the higher red blood cell count, allowing for the best classification metrics in the test set of the binary logistic regression (LR) model, accounting for an AUC of 0.77 with 94% sensitivity and 52% specificity. This study emphasizes the significance of adding hematological patterns in diagnosing these malignancies, which could path further investigations regarding profiling and monitoring at the point of care.

Evaluation of the Hematological Patterns from Up to 985 Days of Long COVID: A Cross-Sectional Study.

Long COVID affects many individuals following acute coronavirus disease 2019 (COVID-19), and hematological changes can persist after the acute COVID-19 phase. This study aimed to evaluate these hematological laboratory markers, linking them to clinical findings and long-term outcomes in patients with long COVID. This cross-sectional study selected participants from a 'long COVID' clinical care program in the Amazon region. Clinical data and baseline demographics were obtained, and blood samples were collected to quantify erythrogram-, leukogram-, and plateletgram-related markers. Long COVID was reported for up to 985 days. Patients hospitalized in the acute phase had higher mean red/white blood cell, platelet, and plateletcrit levels and red blood cell distribution width. Furthermore, hematimetric parameters were higher in shorter periods of long COVID than in longer periods. Patients with more than six concomitant long COVID symptoms had a higher white blood cell count, a shorter prothrombin time (PT), and increased PT activity. Our results indicate there may be a compensatory mechanism for erythrogram-related markers within 985 days of long COVID. Increased levels of leukogram-related markers and coagulation activity were observed in the worst long COVID groups, indicating an exacerbated response after the acute disturbance, which is uncertain and requires further investigation.

Gestational age-specific hematological patterns in preterm infants following necrotizing enterocolitis

Objective To investigate gestational age (GA) specific hematological and transfusion response patterns in preterm infants following necrotizing enterocolitis (NEC) Design A retrospective study comparing hematological/transfusion information in three GA groups’ infants: Group A ≤ 28 weeks. Group B 28–32 weeks, Group C > 32 weeks following necrotizing enterocolitis. Results Group A infants responded with significantly higher WBC count, thrombocytopenia, higher absolute neutrophil, and higher absolute monocyte and lower absolute lymphocyte counts following NEC onset, received more blood transfusions before NEC onset (59.8 versus 30.0%; p = .007), and had higher odds of surgical NEC (OR 3.39 [95% CI 1.19–10.38]; p = .02) than group C. One unit increase in absolute lymphocyte count on the day, and 24 h following NEC was significantly associated with lower surgical NEC odds than groups C. Conclusion The infant’s in-group A had significantly different hematological response patterns following NEC than infants with higher gestational age (groups B and C).

Hematological reference values for Alouatta palliata (Primates: Atelidae) and Cebus imitator (Primates: Cebidae) from the Pacific Coast of Costa Rica

Introduction: Wildlife hematological patterns are fundamental for health monitoring, and allows elucidating variations both within and between populations. Among these, hematological parameters are particularly valuable to evaluate the health status of neotropical primate species in the wild. Objective: To define hematological reference values for two species of monkeys in Costa Rica. Methods: During 2014, we collected blood samples from free-ranging mantled howler monkeys, Alouatta palliata (17 females, 18 males) and white-faced capuchin monkeys, Cebus imitator (5 females, 7 males) in seven localities of the Costa Rican Pacific coast. Results: For both species, the hematological values were higher in males, and howler monkey populations differed significantly except for platelets. Conclusions: These hematological values, which differ by sex and locality, will help evaluate the health status of these neotropical primate populations.

The discovery of multiple myeloma during the evolution of lupus nephropathy: A case report and literature review

Introduction: Systemic lupus erythematosus (SLE) has been proven to be independently associated with higher proportions of malignancies, particularly hematological patterns. We report a patient who developed multiple myeloma on underlying lupus nephropathy with poor outcome. Observation: It was a 48-year-old male patient followed in pneumology for bronchial dilatation secondary to pulmonary tuberculosis who consulted nephrology for an impure nephrotic syndrome without extra-renal signs and a renal biopsy outlining advanced endo and extra-capillary glomerulonephritis with 38% activity. The etiological investigation had revealed lupus. Despite 2 therapeutic protocols based on MMF + corticoids then cyclophosphamide + corticoids, there was no remission. He underwent conservative treatment for chronic kidney disease with stable renal function including a GFR of 27 ml/min/1.73m2. Two years after the discovery of lupus disease, the patient presented with a bleeding syndrome with a blood count showing normocytic normochromic anaemia at 4.1 g/dl, leukopenia at 830/mm3 and thrombocytopenia at 49000/mm3. The bone marrow count performed on the basis of this pancytopenia showed a plasmocytosis in 38% with a dysmorphic erythroblastic lineage (basophilic punctation and laminated cytoplasm), an absent megakaryocytic lineage and the presence of numerous naked plasma cells and dysmorphic plasma cells, numerous hemophagocytic macrophages and siderophages. Plasma protein electrophoresis did not show a monoclonal peak. The outcome was poor. Death occurred 3 days after his hospitalization in a medullary insufficiency course. Conclusion: Lupus can be the starting point for the development of a hematological malignancy at a later stage. On the other hand, cancer can induce spontaneous autoimmune manifestations or secondary to anti-tumor therapies. In our case it was a patient who developed myeloma 2 years after the onset of lupus with a poor outcome leading to death.

Haematological Patterns of Anaemia in Geriatric Patients and Its Etiology: A Study of 500 Cases

Introduction: Anaemia in the elderly is a global health problem, since it is associated with significant morbidity and mortality. The World Health Organization’s criteria consider anaemia when level of haemoglobin is less than 13g/dl in male and 12g/dl in female. Anaemia is easier to miss among the elderly because symptoms such as fatigue, generalized weakness, or mental confusion can be linked to the ageing process. However, anaemia should never be considered as a natural part of growing older.
 Aim: To investigate the haematological pattern of anaemia and its underlying etiology in elderly Indian patients.
 Materials and Methods: A prospective study undertaken over a span of 2 years in a tertiary care hospital in Western Maharashtra. The study included 500 geriatric (>65years) anaemic patients who underwent a complete haemogram and the results were correlated with peripheral blood smear findings. Other diagnostic tests were done as indicated.
 Results: The spectrum encompassed all patterns of anaemia with the most common being normocytic normochromic pattern (57.26%). Overall, there was slight male preponderance (53%) with 65-74 years (69%) being the most common age group afflicted. Maximum number of elderly people had moderate anaemia(56%) in this study; and chronic disease (27.2%) was the most common etiological cause of anaemia followed by iron deficiency (23.4%). Upper gastrointestinal lesions (59%) were the most common causes of iron deficiency anaemia in the present study followed by nutritional deficiency (31.6%).
 Conclusion: Correlation of haemogram and peripheral blood smears is a crucial first step to identify the haematological pattern of anaemia and advise subsequent investigations for assessing and diagnosing it’s etiology. Thus, it plays a role in deciding the management protocol and contributes towards a better quality of life for geriatric anemic patients.

Diagnosis Issues and Management of Nasopharyngeal Non-Hodgkin Lymphomas

Background: Non-Hodgkin lymphomas (NHL) comprise a variety of lymphoproliferative malignancies with certain differences related to the morphological, clinical, immunohistochemical and hematological patterns, as well as the results of treatment. The patients with generalized and relapsed nasopharyngeal NHL experience marked disease burden and unfavorable impact on their life quality and working capacity.Objective: The aim of the study was to characterize the diagnosis issues of NHL with primary involvement of the nasopharynx and evaluate the short- and long-term results of management options.Materials and methods: This analytical and cohort study included 66 patients with different stages of nasopharyngeal NHL, who were managed at the Institute of Oncology from Moldova between 2014-2021. The diagnosis was confirmed by cytological, histopathological and immunohistochemical examinations. The histological types of NHL were verified and distinguished according to the 2017 Revision of WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. The patients treatment, follow-up and researches were realized at the comprehensive cancer center. The study was related to the hospitalized care. The patients age ranged between 19-85 years (average age - 58.4±2,14 years). Males were 28 (42%), females - 38 (58%). Stage I NHL was diagnosed in 10 (15.2%) cases, stage II - in 36 (54.5%), stage III - in 8 (12.1%) and stage IV - in 12 (18.2%). The eligible NHL patients underwent combined chemotherapy (CChT) regimens (CVChlP, R-CVChlP, CHOP and R-CHOP), associated with radiotherapy locoregional treatment in cases of bulky disease or residual tumor masses. The ECOG-WHO score and complete response (CR) rate assessed the short-term results. The long-term results were asserted by the overall one- and 5-year survival.Results: Primary nasopharyngeal NHL occurred commonly in females (58%) and in patients over 60 years (42.4%). The ECOG-WHO score accounted 1-3 at diagnosis. The aggressive NHL were diagnosed mostly (76.1%) in stage I and II due to the earlier developed disease burden. The primary tumor site was localized in the palatine tonsils in 22 (33.3%) patients, in 33 (50%) patients in the pharyngeal tonsil, in 2 (3%) patients in the lingual tonsil. The palatine and pharyngeal tonsils were concomitantly involved in 9 (13.7%) patients. Palatine tonsil involvement occurred mostly in patients over 60 years old, and pharyngeal tonsil involvement - in patients of 40-59 years. CR was achieved in 10 (100%) cases with stage I after combined chemotherapy (CChT) and radiotherapy locoregional treatment. CR occurred in 21 (67.7%), partial response (PR) - in 7 (22.6%) and response failure (RF) - in 3 (9.7%) in stage II NHL after CChT and radiotherapy locoregional treatment. In stage II NHL treated with CChT along, CR was achieved in 1 (25%), PR - in 2 (50%) and RF in 1 (25%). In stage III treated with CChT and radiotherapy locoregional treatment, CR was registered in 1 (20%), PR - in 2 (40%) and RF - in 2 (40%). PR occurred in 2 (66.7%), RF - in 1 (33.3%) in stage III managed with CChT alone. In stage IV NHL, CR was obtained 1 (11.1%) case, PR - in 5 (55.6%), RF - in 3 (33.3%) after CChT and radiotherapy locoregional treatment. PR occurred in 1 (33.3%), RF - in 2 (66.7%) cases in stage IV patients managed with CChT alone. No significant differences of CR rate were found in stage III (12,5%) and stage IV (8.3%) NHL (P>0.05). Irrespective of the stage, the highest CR rate was registered after CChT and radiotherapy locoregional treatment (97.1% of all cases), as compared to CChT alone (2.9% of all cases). The ECOG-WHO score reached 0-1 under the management with CChT and radiotherapy locoregional treatment in all cases with CR and PR. The overall survival was 79.9% at one year and 34.5% at 5 years. One- and 5-year survival proved to be significantly higher în stage I and II NHL - 96.1% and 64.2% respectively. One- and 5-year survival was 79.9% and 34.5% in stage III and IV NHL.Conclusions: Primary nasopharyngeal NHL were outlined by the predominant involvement of females, patients over 60 years and frequent site in the pharyngeal tonsil. The aggressive NHL were revealed commonly in stage I and II due to the progressive disease burden. The rates of the indolent and aggressive NHL turned out to be statistically equal in stage III and IV. The response and overall survival rates proved to be superior after R-CHOP regimen followed by the radiotherapy locoregional treatment. DisclosuresNo relevant conflicts of interest to declare.

Hematological parameters of a Neotropical wild frog population, with a phylogenetic perspective on blood cell composition in Anura.

Hematological parameters can provide key information to an animal health status. However, this information is usually hard to obtain. Here, we described the hematological parameters of Leptodactylus podicipinus in the Brazilian Pantanal. We measured red blood cell morphometrics, erythrogram, and leukogram. We also tested for phylogenetic signal in the erythrogram and leukogram of 48 frog species from 15 families, testing if body size explains their variation. Lymphocytes were the most abundant leukocytes (>60%) in L. podicipinus, followed by neutrophils (∼10%). Given that L. podicipinus is an abundant and widely distributed species in central Brazil, knowing its hematological pattern can help establish a baseline and improve its use as a bioindicator of environmental degradation. Mean corpuscular hemoglobin and value contributed more to the phylomorphospace of erythrogram, in which Leptodactylus spp. and Hypsiboas raniceps had lower values of these variables, whereas Bufotes viridis and Hyla arborea had high values. The phylogenetic signal was spread throughout the dimensions of the leukogram phylomorphospace. The variables that most contributed to it were total leukocytes counts, lymphocytes, and neutrophils. We also found a moderate phylogenetic signal for both the erythrogram and leukogram. Accordingly, body size accounted for a low proportion of variation in both the leukogram (4.7%) and erythrogram (0.57%). By applying phylogenetic comparative methods to hematological parameters, our results add a new perspective on the evolution of blood cell physiology in frogs.

Abstract 954: AO-176, a highly differentiated clinical stage anti-CD47 antibody, is efficacious in pre-clinical models of lymphoma

Abstract Overexpression of CD47 by tumor cells exploits an immune checkpoint that prevents tumor recognition and destruction by innate immune cells. Binding of tumor CD47 to SIRPα on macrophages and dendritic cells triggers a “don't eat me” signal that inhibits phagocytosis enabling escape from innate immune surveillance. Blockade of the CD47/SIRPα axis enables immune recognition and phagocytic clearance of tumor cells. We have developed a clinical stage CD47 targeting antibody AO-176, that is highly differentiated among agents in this class. AO-176 not only blocks the CD47/SIRPα interaction to induce tumor cell phagocytosis, but also: a) directly induces solid and hematologic tumor cell cytotoxicity and damage-associated molecular patterns (DAMPs); b) preferentially binds tumor versus normal cells, which is correlated with β1-integrin expression and localization; c) negligibly binds RBC; and d) exhibits improved binding at acidic pH as found in tumor microenvironments.Previously we have shown that AO-176 is efficacious in a variety of solid tumor xenograft models as well as in models of multiple myeloma and AML. Here, we show the therapeutic potential of AO-176 in pre-clinical models of lymphoma where CD47 is upregulated and associated with poor prognosis. Using a variety of cell based and in vivo models we show that AO-176 demonstrates increased binding to lymphoma cells at an acidic versus physiologic pH and that this binding and blocking of the do not eat me signal leads to enhanced phagocytosis of lymphoma cells either alone or in combination with rituximab. In addition, we show that AO-176 induces annexin V positivity in lymphoma cells as well as inducing a variety of DAMPs that ultimately may aid in inducing immunogenic cell death of the lymphoma cells. We also demonstrate that AO-176 is a potent tumor growth inhibitor in lymphoma xenograft models and appears to induce immune infiltrates as well as inflammatory cytokines.Taken together, these data show that AO-176 has strong therapeutic potential in lymphoma. AO-176 is currently being evaluated in clinical trials of select solid tumors (NCT03834948) and multiple myeloma (NCT04445701). Citation Format: Benjamin J. Capoccia, Michael J. Donio, John O. Richards, Ronald R. Hiebsch, Robyn J. Puro, Arun K. Kashyap, Daniel S. Pereira. AO-176, a highly differentiated clinical stage anti-CD47 antibody, is efficacious in pre-clinical models of lymphoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 954.

Investigation of the antimicrobial activity and hematological pattern of nano-chitosan and its nano-copper composite

Novel synthesized Chitosan–Copper oxide nanocomposite (Cs–CuO) was prepared using pomegranate peels extract as green precipitating agents to improve the biological activity of Cs-NP's, which was synthesized through the ionic gelation method. The characterization of biogenic nanoparticles Cs-NP's and Cs–CuO-NP's was investigated structurally, morphologically to determine all the significant characters of those nanoparticles. Antimicrobial activity was tested for both Cs-NP's and Cs–CuO-NP's via minimum inhibition concentration and zone analysis against fungus, gram-positive and gram-negative. The antimicrobial test results showed high sensitivity of Cs–CuO-NP's to all microorganisms tested in a concentration less than 20,000 mg/L, while the sensitivity of Cs-NP's against all microorganisms under the test started from a concentration of 20,000–40,000 mg/L except for the C. albicans species. The hematological activity was also tested via measuring the RBCs, platelet count, and clotting time against healthy, diabetic, and hypercholesteremia blood samples. The measurement showed a decrease in RBCs and platelet count by adding Cs-NP’s or Cs–CuO-NP's to the three blood samples. Cs-NP's success in decreasing the clotting time for healthy and diabetic blood acting as a procoagulant agent while adding biogenic CuO-NP’s to Cs-NP’s increased clotting time considering as an anti-coagulant agent for hypercholesteremia blood samples.

Impact of Low Hemoglobin on Body Composition, Strength, and Redox Status of Older Hemodialysis Patients Following Resistance Training.

IntroductionThe purpose of this study was to: (i) investigate the effect of six months of resistance training (RT) on body composition, muscle strength, hematological patterns, and redox profile in maintenance hemodialysis (HD) patients, and; (ii) evaluate the effects of baseline concentrations of hemoglobin on the RT response.MethodsOne hundred fifty-seven subjects with chronic kidney disease (CKD) were randomly allocated into two groups: Control [CTL, (n = 76)] and RT (n = 81). A first visit was required for anamnesis and anthropometric measurements. Venous blood samples were collected at baseline and after twenty-four weeks of training in all patients for the analysis of clinical and redox balance markers. The RT program spanned six months and consisted of three sets of 8–12 repetitions with a rating of perceived exertion between 5 and 8 for three weekly sessions. Each exercise session was performed in twelve resistance exercises and it least for approximately 40 min.ResultsThe main results demonstrated that RT decreased waist circumference by 3%, and decreased thiobarbituric reactive species (TBARS) by 28%. Moreover, RT increased handgrip strength by 28.4%, fat-free mass by 4.1%, hemoglobin by 5%, iron by 33.4%, glutathione by 121%, and Trolox equivalent antioxidant capacity by 14.2% (p < 0.05). Low hemoglobin concentrations impaired the effect of RT on fat-free mass gain.ConclusionSix months of RT in HD patients improved clinical parameters, such as hemoglobin, iron, body composition, and redox balance, while low hemoglobin concentration impaired exercise-benefits on fat-free mass in patients with CKD. These findings can contribute to a better clinical application of RT in the maintenance of hemodialysis patients.

A Clinico-Hematological Pattern of Bleeding Disorders in Children at a Tertiary Care Teaching Hospital

Bleeding disorders (BDs) are quite uncommon, and most bleeding episodes commonly encounter in children as a result of local factors. However, the available literature is not enough to demonstrate the commonly encountered BDs among children. Hence, this study was intended to demonstrate the hematological pattern of BD’s over different age groups of children. In this prospective study, 100 patients of either gender, aged between 0 to 12 years attending the pediatric ward with bleeding manifestations were evaluated clinically to identify an underlying etiology by physical, familial and hematological examination. The data on demographics, family history, the onset of bleeding manifestations, laboratory findings, diagnosis with respective etiologies were collected, tabulated and interpreted. Out of 100 cases,38% had acquired BDs, followed by platelet disorders (32%), inherited (26%) and vascular BDs (4%). Among acquired cases, disseminated intravascular coagulation (25/100) with hepatic impairment (40%) is the predominant cause. In inherited cases, von-willebrand factor deficiency (18/100) was more predominant than factor VIII deficiency (12/100). School going children (6-9 years; 32%) and infants (21%) were the most affected age groups. Anemia (69%) and growth retardation (13%) were commonly observed complications. Acquired coagulopathies contribute a major portion of bleeding disorders in children. Infants and school-going children are at greater risk to develop coagulopathies. The understanding etiological cause is essential for accurate diagnosis and management in order to prevent morbidity associated with coagulopathies in children.

Childhood Vitiligo: A hospital based retrospective study in Coastal South India

Vitiligo is an acquired, multifactorial disorder of depigmentation and is overwhelming and distressing to the patients and the care givers. Childhood vitiligo has different characteristics as compared to adult-onset vitiligo. Every parent wants to know if the disease will progress or regress. To study the epidemiological, clinical and hematological patterns of children with vitiligo. First 50 patients with vitiligo, younger than 12 years of age, who visited the Dermatology outpatient department of Vinayaka Missions Hospital, a tertiary care center in Karaikal, between January 2015 and January 2020 were included. They were assessed for the natural history, clinical features, family history and associated abnormalities of vitiligo. There were 19 boys and 31 girls (boys: girls 1:1.63) out of 50 patients. Mean age of onset of vitiligo was 5.8 years and mean duration was 1.4 years. The most common site was the head and the neck, followed by the extremities, trunk and genitalia and the most prevalent type was vitiligo vulgaris (60%). Then, it was acrofacial vitiligo (26.5%), focal vitiligo (23.7%) and segmental vitiligo (2.6%). 5 patients had a positive family history. Involvement of mucosa in 12%, Leukotrichia in 11% and Koebnerization was seen in 10% children. Body involvement is bilateral in 72% and unilateral in 28% children. Majority of patients (49%) had multiple lesions (more than 5) and most (96%) had &amp;#60;5% body surface area involved. In children, any depigmented/hypopigmented lesion should be evaluated and followed up properly to rule out vitiligo. The patterns and characteristics of childhood-onset vitiligo should be understood properly by Dermatologists as it presents in a different manner from adult-onset disease and its management should take several factors into consideration like extension, psychological effects on children and parents, avoidance of treatment side effects and probable association with other autoimmune diseases.

Incidence and Clinico - Hematological pattern of Diamond Blackfan Anemia: 10 years experience in a single center

The study aimed to determine the incidence and clinico-hematological pattern of Diamond Blackfan Anemia (DBA), a congenital form of pure red cell aplasia (PRCA). A retrospective observational descriptive cohort study was conducted in the Department of Pediatric Hematology and Transfusion Medicine, The Children’s Hospital and The Institute of Child Health, Lahore, for a period of 10 years (January 2008 to December 2017.) Data was analyzed using SPSS software. Among 19,475 cases reviewed, 74 patients (0.4%) were diagnosed as congenital PRCA with a male to female ratio of 4.2:1 and a mean age of 5months. In this cohort, 23% of patients had a positive family history. Thirty-four percent of patients presented with congenital anomalies involving cleft lip and palate (23.5%), thumb and upper limb defects (20.5%), craniofacial anomalies (14.7%), and cardiac and urogenital malformations in 8.8 and 5.8% patients, respectively. Red blood cell (RBC) counts and hemoglobin (Hb) concentration levels were low with a range of 0.5–3.0 × 1012/μl and 2.5–6.5 g/dl, respectively. Fetal hemoglobin (HbF) levels remained within the range of 2–20%. Bone marrow aspirate showed <5% erythroblasts in all patients. The specific clinico-hematological pattern as described in our study not only helps in early diagnosis and management of the disease and also paves way to establish a data registry.

Assessment of the results and hematological side effects of 3D conformal and IMRT/ARC therapies delivered during craniospinal irradiation of childhood tumors with a follow-up period of five years

BackgroundCraniospinal irradiation (CSI) of childhood tumors with the RapidArc technique is a new method of treatment. Our objective was to compare the acute hematological toxicity pattern during 3D conformal radiotherapy with the application of the novel technique.MethodsData from patients treated between 2007 and 2014 were collected, and seven patients were identified in both treatment groups. After establishing a general linear model, acute blood toxicity results were obtained using SPSS software. Furthermore, the exposure dose of the organs at risk was compared. Patients were followed for a minimum of 5 years, and progression-free survival and overall survival data were assessed.ResultsAfter assessment of the laboratory parameters in the two groups, it may be concluded that no significant differences were detected in terms of the mean dose exposures of the normal tissues or the acute hematological side effects during the IMRT/ARC and 3D conformal treatments. Laboratory parameters decreased significantly compared to the baseline values during the treatment weeks. Nevertheless, no significant differences were detected between the two groups. No remarkable differences were confirmed between the two groups regarding the five-year progression-free survival or overall survival, and no signs of serious organ toxicity due to irradiation were observed during the follow-up period in either of the groups.ConclusionThe RapidArc technique can be used safely even in the treatment of childhood tumors, as the extent of the exposure dose in normal tissues and the amount of acute hematological side effects are not higher with this technique.

Toxicological and Positive Changes in Hematological Pattern of Albino Rats Treated with Termitomyces Titanicus: Potential Valorization of an Indigenous Practice in the Treatment of Oris Cancrum (Noma) in Nigeria

A neglected disease affecting many malnourished children and immunosuppressed patients in sub Saharan Africa is noma caused mainly by Fusobacterium necrophorum. Poverty and malnutrition are highly implicated in the epidemiology, prevalence and poor management of noma. Local mushroomsof the gens Termitomyces have been used in parts of northern Nigeria and Cameroon to improve health of noma patients, but detail studies to authenticate the effect of this medicinal mushroom on specific chronic diseases such as noma remain inadequate. Blood transfusion remains one of the critical palliative care strategies to manage anemia in noma disease. The current preliminary study was undertaken to establish the effect of a strain of termitomyces titanicus mushroom, which has been used in Nigerian and Cameroonian folk medicine in Itas Gadau Local government and parts of Bauchi State and North west Region respectively for the management of anemia, using hematological parameters such as hemoglobin level, white blood cell stabilization and packed cell volume of albino rats and also to ascertain its safety for consumption using liver enzyme profiling. The results indicated that rats treated with Termitomyces titanicus had a higher hemoglobin level (12.2 g/dl) compared to a treatment with vitamin B complex (11.3 g/dl) and untreated (10.1 g/dl). A significant increase in the total white blood cell level (26300cells/mm3) was observed with rats treated with mushrooms compared with 7500 cells/mm3 for rats treated with vitamin B complex. Hematological parameters showed a significant difference amongst the test group compared with the controls group. The results further revealed that rats treated with termitomyces had a cleaner liver than with rats treated with vitamin B complex. The results authenticate the practice of using this mushroom in the local management of anemic conditions in Oris cancrum (noma) patients and other chronic disease conditions such as cancer