Hematological Tests Research Articles

Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a tertiary care teaching hospital in Addis Ababa, Ethiopia: a cross-sectional study

BackgroundIn low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Therefore, we performed this study among newly confirmed CML patients at Tikur Anbesa Specialized Hospital (TASH), Ethiopia.ObjectiveTo determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at tertiary care teaching hospital in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted to evaluate hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at TASH from August 2021 to December 2022. A structured questionnaire was used to collect the patients’ sociodemographic information, medical history and physical examination, and blood samples were also collected for hematological, cytogenetic and molecular tests. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants.ResultsA total of 251 confirmed new CML patients were recruited for the study. The majority of patients were male (151 [60.2%]; chronic (CP) CML, 213 [84.7%]; and had a median age of 36 years. The median (IQR) WBC, RBC, HGB and PLT counts were 217.7 (155.62–307.4) x103/µL, 3.2 (2.72–3.6) x106/µL, 9.3 (8.2–11) g/dl and 324 (211–499) x 103/µL, respectively. All patients had leukocytosis, and 92.8%, 95.6% and 99.2% of the patients developed anemia, hyperleukocytosis and neutrophilia, respectively. Fatigue, abdominal pain, splenomegaly and weight loss were the common signs and symptoms observed among CML patients. Approximately 86.1% of the study participants were Philadelphia chromosome positive (Ph+) according to fluorescence in situ hybridization (FISH). P210, the major breakpoint protein, transcript was detected by both qualitative polymerase chain reaction (PCR) and quantitative real time polymerase chain reaction (PCR).ConclusionDuring presentation, most CML patients presented with hyperleukocytosis, neutrophilia and anemia at TASH, Addis Ababa. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most CML patients were diagnosed by FISH, and p120 was detected in all CML patients diagnosed by PCR. The majority of CML patients arrive at referral center with advanced signs and symptoms, so better to decentralize the service to peripheral health facilities.

A machine learning screening model for identifying the risk of high-frequency hearing impairment in a general population

BackgroundHearing impairment (HI) has become a major public health issue in China. Currently, due to the limitations of primary health care, the gold standard for HI diagnosis (pure-tone hearing test) is not suitable for large-scale use in community settings. Therefore, the purpose of this study was to develop a cost-effective HI screening model for the general population using machine learning (ML) methods and data gathered from community-based scenarios, aiming to help improve the hearing-related health outcomes of community residents.MethodsThis study recruited 3371 community residents from 7 health centres in Zhejiang, China. Sixty-eight indicators derived from questionnaire surveys and routine haematological tests were delivered and used for modelling. Seven commonly used ML models (the naive Bayes (NB), K-nearest neighbours (KNN), support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGBoost), boosting, and least absolute shrinkage and selection operator (LASSO regression)) were adopted and compared to develop the final high-frequency hearing impairment (HFHI) screening model for community residents. The model was constructed with a nomogram to obtain the risk score of the probability of individuals suffering from HFHI. According to the risk score, the population was divided into three risk stratifications (low, medium and high) and the risk factor characteristics of each dimension under different risk stratifications were identified.ResultsAmong all the algorithms used, the LASSO-based model achieved the best performance on the validation set by attaining an area under the curve (AUC) of 0.868 (95% confidence interval (CI): 0.847–0.889) and reaching precision, specificity and F-score values all greater than 80%. Five demographic indicators, 7 disease-related features, 5 behavioural factors, 2 environmental exposures, 2 hearing cognitive factors, and 13 blood test indicators were identified in the final screening model. A total of 91.42% (1235/1129) of the subjects in the high-risk group were confirmed to have HI by audiometry, which was 3.99 times greater than that in the low-risk group (22.91%, 301/1314). The high-risk population was mainly characterized as older, low-income and low-educated males, especially those with multiple chronic conditions, noise exposure, poor lifestyle, abnormal blood indices (e.g., red cell distribution width (RDW) and platelet distribution width (PDW)) and liver function indicators (e.g., triglyceride (TG), indirect bilirubin (IBIL), aspartate aminotransferase (AST) and low-density lipoprotein (LDL)). An HFHI nomogram was further generated to improve the operability of the screening model for community applications.ConclusionsThe HFHI risk screening model developed based on ML algorithms can more accurately identify residents with HFHI by categorizing them into the high-risk groups, which can further help to identify modifiable and immutable risk factors for residents at high risk of HI and promote their personalized HI prevention or intervention.

Pathological changes of biochemical, hematological and coagulation analyses in patients with COVID-19 disease

The identification of patients with poor prognosis and early detection of COVID-19 disease complications are made possible by pathological analyses of routine hematological, coagulation, and biochemical tests. Interpreting analyses needs to be done within the framework of each patient’s unique clinical picture. It’s also critical to keep an eye on changes at the individual parameter level. From May 20th, 2021, to March 30th, 2024, a comprehensive search of literature was carried out using international databases, such as PubMed, Embase, Web of Science, Scopus, and the Cochrane Library, in compliance with the PRISMA guidelines. The research question was formulated using the PICO strategy. The following terms were used: biochemical parameters in COVID-19, hematological parameters in COVID-19, blood coagulation parameters in COVID-19, indicators of inflammation, and indicators of tissue damage in SARS-CoV-2. Routine hematological, coagulation, and biochemical tests are primarily used to monitor the progression of the disease and the effectiveness of treatment rather than being utilized for the established diagnosis of COVID-19 due to their low specificity. Molecular genetics and immunological techniques should be used to determine the COVID-19 disease diagnosis.

Web-accessible critical limits and critical values for urgent clinician notification.

To survey the World Wide Web for critical limits/critical values, assess changes in quantitative low/high thresholds since 1990-93, streamline urgent notification practices, and promote global accessibility. We identified Web-posted lists of critical limits/values at university hospitals. We compared 2023 to 1990-93 archived notification thresholds. We found critical notification lists for 26 university hospitals. Laboratory disciplines ranged widely (1-10). The median number of tests was 62 (range 21-116); several posted policies. The breadth of listings increased. Statistically significant differences in 2023 vs. 1990 critical limits were observed for blood gas (pO2, pCO2), chemistry (glucose, calcium, magnesium), and hematology (hemoglobin, platelets, PTT, WBC) tests, and for newborn glucose, potassium, pO2, and hematocrit. Twenty hospitals listed ionized calcium critical limits, which have not changed. Fourteen listed troponin (6), troponin I (3), hs-TnI (3), or troponin T (2). Qualitative critical values expanded across disciplines, encompassing anatomic/surgical pathology. Bioterrorism agents were listed frequently, as were contagious pathogens, although only three hospitals listed COVID-19. Only one notification list detailed point-of-care tests. Two children's hospital lists were Web-accessible. Urgent notifications should focus on life-threatening conditions. We recommend that hospital staff evaluate changes over the past three decades for clinical impact. Notification lists expanded, especially qualitative tests, suggesting that automation might improve efficiency. Sharing notification lists and policies on the Web will improve accessibility. If not dependent on the limited scope of secondary sources, artificial intelligence could enhance knowledge of urgent notification and critical care practices in the 21st Century.

Repeated-dose toxicity and toxicokinetic study of isobutylparaben in rats subcutaneously treated for 13weeks.

Parabens have historically served as antimicrobial preservatives in a range of consumables such as food, beverages, medications, and personal care products due to their broad-spectrum antibacterial and antifungal properties. Traditionally, these compounds were believed to exhibit low toxicity, causing minimal irritation, and possessing limited sensitization potential. However, recent evidence suggests that parabens might function as endocrine-disrupting chemicals (EDCs). Consequently, extensive research is underway to elucidate potential human health implications arising from exposure to these substances. Among these parabens, particular concerns have been raised regarding the potential adverse effects of iso-butylparaben (IBP). Studies have specifically highlighted its potential for inducing hormonal disruption, significant ocular damage, and allergic skin reactions. This study aimed to evaluate the prolonged systemic toxicity, semen quality, and estrus cycle in relation to endocrine disruption endpoints, alongside assessing the toxicokinetic behavior of IBP in Sprague-Dawley rats following a 13-week repeated subcutaneous administration. The rats were administered either the vehicle (4% Tween 80) or IBP at dosage levels of 2, 10, and 50mg/kg/day for 13weeks. Blood collection for toxicokinetic study was conducted on three specified days: day 1 (1st), day 30 (2nd), and day 91 (3rd). Systemic toxicity assessment and potential endocrine effects were based on various parameters including mortality rates, clinical signs, body weights, food and water consumption, ophthalmological findings, urinalysis, hematological and clinical biochemistry tests, organ weights, necropsy and histopathological findings, estrus cycle regularity, semen quality, and toxicokinetic behavior. The findings revealed that IBP induced local irritation at the injection site in males at doses ≥ 10mg/kg/day and in females at 50mg/kg/day; however, systemic toxicity was not observed. Consequently, the no-observed-adverse-effect level (NOAEL) for IBP was determined to be 50mg/kg/day in rats of both sexes, indicating no impact on the endocrine system. The toxicokinetics of IBP exhibited dose-dependent systemic exposure, reaching a maximum dose of 50mg/kg/day, and repeated administration over 13weeks showed no signs of accumulation.

Clinical factors and major pathological response after neoadjuvant chemoimmunotherapy in potentially resectable lung squamous cell carcinoma.

Major pathological response (MPR) helps evaluate the prognosis of patients with lung squamous cell carcinoma (LUSC). However, the clinical factors that affect the achievement of MPR after neoadjuvant chemoimmunotherapy (NCIO) in patients with LUSC remain unclear. This study aimed to explore the clinical factors affecting the MPR after NCIO in patients with potentially resectable LUSC. This retrospective study included patients with stage IIB-IIIC LUSC who underwent surgical resection after receiving NCIO at a center between March 2020 and November 2022. In addition to the postoperative pathological remission rate, sex, age, body mass index (BMI), smoking history, TNM stage, hematological and imaging test results, and other indicators were examined before NCIO. According to the pathological response rate of the surgically removed tumor tissue, the patients were split into MPR and non-MPR groups. In total, 91 LUSC patients who met the study's eligibility criteria were enrolled: 32 (35%) patients in the non-MPR group and 59 (65%) in the MPR group, which included 43 cases of pathological complete remission (pCR). Pre-treatment lymphocyte level (LY) (odds ratio [OR] =5.997), tumor burden (OR=0.958), N classification (OR=15.915), radiographic response (OR=11.590), pulmonary atelectasis (OR=5.413), and PD-L1 expression (OR=1.028) were independently associated with MPR (all P < 0.05). Based on these six independent predictors, we developed a nomogram model of prediction having an area under the curve (AUC) of 0.914 that is simple to apply clinically to predict the MPR. The MPR group showed greater disease-free survival (DFS) than the non-MPR group, according to the survival analysis (P < 0.001). The MPR rate of NCIO for potentially resectable LUSC was 65%. LY, tumor burden, N classification, radiographic response, pulmonary atelectasis, and PD-L1 expression in patients with LUSC before NCIO were the independent and ideal predictors of MPR. The developed nomogram demonstrated a good degree of accuracy and resilience in predicting the MPR following NCIO, indicating that it is a useful tool for assuring customized therapy for patients with possibly resectable LUSC.

Hematological and Biochemical Profiles of Patients with Dengue Virus Infection in Lalitpur, Nepal

Dengue viral infection is a disease transmitted by mosquitoes of the Aedes genus, and it arises as a result of being bitten by mosquitoes that are carrying the virus. This infection induces a wide range of changes in the body’s immune system. Thus serological evaluation together with hematological and biochemical parameters in cases of dengue viral infection make an accurate clinical diagnosis. The main objective of this study was to study the serological, hematological, and biochemical parameters among patients infected with Dengue virus. A total of 102 blood samples were collected at Asrik Diagnostic Lab, Lalitpur during the period of August to October 2022. Samples were analyzed by following methods: hematological tests were done by coulter counter, Biochemical tests were done by fully automated analyzer and serological tests were done by ELISA. Of the 102 blood samples NS1 antigen was detected in 62 (60.9%) whereas anti-dengue IgM antibody was detected in 10 (9.8%). Leukopenia and thrombocytopenia were present in 33 (53.1%) and 32 (51.6%) of the 62 NS1 positive samples, respectively. Of the 62 cases, only 16 samples were tested for the alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Out of 16 samples, ALT and AST level were significantly higher in 11 (68.8%) and 14 (87.5%) positive cases, respectively. The statistical analysis showed that there was no significant association between NS1 and IgM. It can be concluded that the investigation of leukocytes, thrombocytes, ALT, and AST helps to diagnose the dengue efficiently.

Association of Hematological and Biochemical Parameters and HLA-DRB1 Alleles With Anti-cyclic Citrullinated Peptide Autoantibodies in Sudanese Rheumatic Patients.

Introduction Anti-citrullinated protein/peptide antibodies (ACPA) are crucial for the diagnosis and prognosis of rheumatoid arthritis (RA) and are associated with class II HLA-DRB1 alleles. The study's goal was to determine howDRB1alleles and hematological and biochemical parameters affect ACPA production in RA patients from Sudan. Methods The study analyzed the hematological and biochemical parameters and the frequency ofHLA-DRB1alleles in 120 RA patients and 100 controls. Automated analyzers, ELISA, the latex agglutination test, and the Westergren method were utilized for hematological and biochemical testing. HLA class II alleles were genotyped using polymerase chain reaction-sequence-specific primers (PCR-SSP). The student's t-test and the chi-square (Χ2) test were employed to identify significant alterations between the examined parameters and allele frequencies. Results A total of 51.7% of 120 RA patients tested positive for ACPA (ACPA+). Among those patients, theDRB1*04and*10alleles were significantly more prevalent (22.2% vs. 8.9%, P = 0.048 and 23.8% vs. 8.9%, P = 0.030, respectively). RA patients had significantly higher counts of platelet count test (PLT; P= 0.011), lymphocytes (LY; P =0.000), neutrophils (NE; P= 0.025), monocytes (MO; P= 0.000), eosinophils (EO; P= 0.000), neutrophil-to-lymphocyte ratio (NLR; P= 0.006), C-reactive protein (CRP; P= 0.000), and erythrocyte sedimentation rate (ESR; P= 0.000) than controls. Patients also showed low counts of red blood cells (RBC; P= 0.003), hemoglobin (Hb; P= 0.024), mean platelet volume (MPV; P= 0.000), and basophils (BA; P= 0.048). ACPA+RA patients had elevated white blood cells (WBC; P= 0.046), PLT (P= 0.029), and low mean corpuscular hemoglobin concentration (MCHC; P =0.022). The hematological and biochemical parameters of ACPA+RA patients with theDRB1*04or*10alleles did not differ significantly. Conclusions We found significant differences in hematological and biochemical parameters between RA patients and controls that had nothing to do with ACPA positivity or the frequency ofDRB1*04or*10alleles.

Neutrophil volume, conductivity, and scatter (VCS) as a screening tool in neonatal sepsis

Background The aim of the study is to establish changes in Neutrophil volume, conductivity, and scatter (VCS) in neonatal sepsis and to determine appropriate cutoff levels to be used as a screening tool for neonatal sepsis. Methods This prospective observational study was conducted at the Neonatal Intensive care Units at Ain Shams University. It included 25 septic neonates diagnosed based on the presence of risk factors of sepsis, clinical or laboratory evidence suggestive of sepsis, and positive blood culture results. A control group of 25 age-matched neonates was also included. Blood counts were processed in the automated hematology analyzer, Beckman coulter LH 750. Neutrophil VCS Parameters were analyzed and correlated with different clinical and laboratory data of the study sample. Results In this study, the value of mean neutrophil volume (MNV) was significantly increased, and the value of mean neutrophil scatter (MNS) was significantly decreased in the septic group compared with the control group, with P value = 0.026 and 0.025, respectively. The MNV showed a sensitivity of 96%, a specificity of 48%, a PPV of 64.9%, an NPV of 92.3%, and a cutoff point of &gt;140.2 with AUC of 0.713. The MNS showed a sensitivity of 68%, a specificity of 92%, a PPV of 89.5%, a NPV of 74.2%, and a cutoff point of ≤129.4 with an AUC of 0.718. Conclusion Although neutrophil VCS parameters cannot be used alone to diagnose or rule out neonatal sepsis, they aid as additional markers for early diagnosis of neonatal sepsis. They can also be used in combination with other hematological screening tests to improve the diagnostic accuracy of the neonatal sepsis screen.

Enhancing Quality in Hematology Laboratory Testing: A Comprehensive Review of Preanalytical Phase Errors and Prevention Strategies

Abstract: This comprehensive review explores the critical importance of the preanalytical phase in hematology laboratory testing and its significant impact on the overall quality of results. The preanalytical phase encompasses all the processes from sample collection to sample preparation, and any errors during this stage can lead to inaccurate and unreliable hematological data. By systematically examining the various sources of preanalytical errors, including specimen collection, transportation, and handling, this review provides insights into the potential challenges faced in the hematology laboratory. Furthermore, the article discusses a range of effective prevention strategies to mitigate preanalytical phase errors and enhance the reliability of hematological test results. These strategies encompass improvements in staff training, standardization of collection procedures, implementation of quality control measures, and advancements in technology and automation. The review emphasizes the importance of fostering a culture of awareness and adherence to best practices in the laboratory setting. Preanalytical errors remain a major concern in every laboratory because the majority of the stages leading up to these errors are not within the direct control of the laboratory. Even though they cannot be eliminated, they can definitely be minimized. The preanalytical errors of a hematology laboratory can be reduced with the help of quality management systems, personnel training, regular audits, and automation in the preanalytical stage, thus increasing the accuracy of the results and providing better patient care.

Clozapine clinical toolkit optimizes inpatient clozapine monitoring.

Clozapine is the most effective antipsychotic in the management of treatment-resistant schizophrenia; however, its use is challenging due to the risk of severe adverse effects. Despite the risks associated with clozapine, there is no mandatory monitoring in Canada beyond hematologic testing for agranulocytosis surveillance. This study focuses on the development, implementation, and evaluation of a clozapine clinical toolkit (CTK) targeted at optimizing inpatient clozapine use. A comprehensive literature review was conducted to identify clozapine best practices, experts were consulted, and a comprehensive clozapine CTK was developed and implemented at a large Canadian tertiary hospital in December 2018. To evaluate the CTK, a retrospective chart review was conducted to assess for change in guideline-concordant monitoring pre- and post- CTK implementation. Patients were included if they were > 18 years of age and received clozapine during inpatient admission. Results were analyzed using descriptive and inferential statistics. Among the charts reviewed, 185 and 113 admissions met the pre- and post-CTK inclusion criteria, respectively. Staff used the CTK in the care of 96% of clozapine patients post implementation, and its use resulted in improvements in guideline-concordant monitoring for agranulocytosis and myocarditis. Implementation of the clozapine CTK increased the concordance of clozapine monitoring with best practice recommendations. Future research is necessary to assess the impact of the CTK on clinical outcomes and patient satisfaction.

Risk factors for neonatal cholestasis in small gestational age infants: case report and literature review

Cholestatic jaundice, defined as conjugated bilirubin levels higher than 1 mg/dl, is a bile formation and excretion disturbance. Its incidence is estimated at 1 case in 2500 live births, being 100-200 times higher in preterm infants less than 28 weeks gestational age. It occurs in biliary atresia, infectious diseases, endocrine and inherited metabolic diseases, Alagille Syndrome, preterm and intrauterine growth-restricted newborns, lack of enteral feeding, and is more frequent in male gender. It is a frequent complication of parenteral nutrition. In preterm and small for gestational age (SGA) infants, the etiology of cholestasis is multifactorial. Early diagnosis enables early therapeutic intervention. We report the case of an SGA male preterm infant. He was born by C-section for fetal distress at 30 weeks gestational age with an 800 g birth weight. He developed mild respiratory distress, hypoglycemia, meconium ileus, and early cholestasis. Complex hematological, serological, and immunological tests were carried out; ultrasound evaluations were performed. The final diagnosis was cholestasis of multifactorial etiology in a preterm infant with severe intrauterine growth restriction (IUGR). Treatment with ursodeoxycholic acid was started. Three months later, the transaminases, bilirubin, gammaglutamyl transferase (GGT), and alkaline phosphatase (ALP) triglycerides returned to normal. Conclusion. Cholestasis in SGA infants is a severe condition potentially associated with life-threatening complications, requiring complex diagnostic evaluation.

A retrospective study of hematological and biochemical parameters in coronavirus disease 2019 (COVID-19) patients in Vietnam

The coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus has had a serious impact on global public health. Currently, there are not many studies evaluating the impact of COVID-19 on changes in biochemical and hematological parameters of COVID-19 patients in Vietnam. This study aimed to investigate clinical characteris tics and changes in hematological and biochemical parameters in COVID-19 patients. This retrospective and cross-sectional study collected the medical records of 654 COVID-19 patients treated at Dong Nai General Hospital from August to December 2021. Medical information from COVID-19 patients was collected through handwritten medical records and HIS-FP software. The age of the study population was 56.69±15.97. Diabetes was the most common comorbidity and had a significant relationship with COVID-19 severity and mortality. For hematological tests, total white blood cell (WBC) and Percentage of neutrophils (%NEU) in non-survivors (12.87±6.45) signifi- cantly increased compared with survivors (9.08±4.48) (p&lt;0.001). Neutrophils (NEU), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) increased in both non-survivors and survivors; lymphocytes (LYM) and percentage of lymphocyte (%LYM) decreased in both groups. For biological parameters, aspartate transaminase (AST) in non-survivors [55.9 (38.5–89.1)] significantly increased compared with survivors [36.55 (23.02–67.12)] (p&lt;0.001). Lactate dehy drogenase (LDH) activity, C-reactive protein (CRP), and D-dimer levels increased in both non-survivors and survivors. NEU, LYM, NLR, PLR, LDH, CRP, and D-dimer were related to the severity of COVID-19 disease.

Acute and subacute toxicological evaluation of the ethanol leaf extract of Morus mesozygia stapf. (Moraceae) in rodents

Ethnopharmacological relevanceTraditionally, the Morus mesozygia tree leaf has been used to manage maladies such as peptic ulcer, hyperglycemia, dermatitis, rheumatism, stomach-ache, arthritis, cough, malignancies, and malaria in parts of Africa. Aim of the studyThe study aimed to evaluate the potential of ethanol leaf extract of Morus mesozygia (EEMm) to induce toxicity by employing both acute and sub-acute oral toxicity experimental models. Material and methodsThe extract's cytotoxicity was studied using brine shrimps (Artemia salina) lethality assay (BSLA), while in the acute toxicity test, male and female mice were administered a single oral dose of EEMm (2000 mg/kg). Male and female Wistar rats received repeated doses of 100 or 500 mg/kg EEMm orally for 28 days in the sub-acute toxicity experiment. The phytochemical analysis of EEMm was done using the HPLC. ResultsThe BSLA revealed a moderate cytotoxic potential of the extract, with an LC50 of 567.13 ± 0.27 μg/mL. All the animals survived the acute toxicity test, with no significant changes in the relative organ weights, suggesting that LD50 is greater than 2000 mg/kg. The animal weights did not vary significantly in the sub-acute toxicity test neither were the alterations in biochemical and hematological tests pronounced, although the histoarchitectures of the kidney, liver and spleen indicated slight anomalies in the evaluated animals. The HPLC analysis revealed the presence of quercetin, ferulic acid, rutin, caffeic acid, morin and gallic acid. ConclusionsEthanol leaf extract of Morus mesozygia demonstrated a safe toxicity profile in rodents, supporting its broad folkloric use in African ethnomedicine.

Diagnosis and surgical treatment of associated papillary lung adenocarcinoma to canine distemper: case report

Lung neoplasms in dogs have a multifactorial etiology, and animals aged 10 or older are the most affected, with no sexual or racial predisposition. Adenocarcinoma is the most common type of cancer and represent around 80% of the cases. The aim of this study was to describe a case of an 11-year-old dog of no defined breed (SRD) with papillary lung adenocarcinoma and canine distemper virus. Clinical examination revealed a body condition score (BCS: 5.0), normocardial, tachypneic, normothermic, mild dehydration (5 - 6%), hyporexia, hypocolored mucous membranes, normodipsia, normuria and normoquesia. Hematological tests (blood count, biochemistry) were carried out, initially showing leukocytosis and regenerative anemia. Imaging tests of the chest (x-ray) and computed tomography (CT) showed a nodule, with approximately 7cm in circumference in the ventral portion of the right caudal lung lobe. Treatment was by thoracotomy to excise the nodule. The excised material was sent for histopathological and immunohistochemical diagnosis, which confirmed the diagnosis of lung adenocarcinoma. Infection with the distemper virus was confirmed by the identification of the Lentz corpuscle, which was found in the blood sample during the differential leukocyte count, when the animal was returned for re-evaluation. The animal did not respond to treatment and died 48 hours after the diagnosis of distemper, in response to cardiorespiratory arrest, 12 days after the removal of the nodule. Infection with the distemper virus led to an unfavorable prognosis and made post-surgical treatment impossible, culminating in the animal's death.

Acute Myeloid Leukemia in a Three-Year-Old Girl Mimicking Chronic Myeloid Leukemia in Blast Crisis, Challenge in Diagnosis and Treatment in Limited-Resourced Health Care Facility: A Case Report

Introduction: : Acute myeloid leukemia (AML) is the second most common hematologic cancer in childhood. Clinically, AML has similar symptoms to other types of leukemias, and diagnosis remains a challenge due to limited access to pediatric hemato-oncology diagnostic examination. This study aims to report AML in a 3-year-old girl who was first suspected of Chronic Myeloid Leukemia (CML) in blast crisis, using a combination of clinical-hematology parameters and conventional morphology examination in a limited-resourced healthcare facility. Case Presentation: A 3-year-old girl was referred from a rural Eastern Indonesia hospital with symptoms of prolonged fever, leucocytosis, severe anemia, and severe thrombocytopenia. In the previous hospital, the patient had a history of hyperleukocytosis and peripheral blood smear suspected of CML in blast crisis. A peripheral blood smear was repeated in our hospital and showed findings of Auer rod cells suggesting AML. Two bags of packed red cells and 2 thrombocyte concentrations were administered before referral for further diagnostic evaluation with bone marrow aspiration. Bone marrow aspiration revealed multiple nucleoli suggested for AML with FAB classification as M4 subtypes, and she received chemotherapy in a tertiary hospitalConclusions: With limited resources, suspicion based on persistent clinical symptoms, routine hematology tests, and peripheral blood smear examination are important to distinguish AML from CML in blast crisis. Understanding clinical hematology parameters and peripheral blood smears is the first step in AML diagnosis pathway and decision for further diagnostic referral. Supportive therapy and early recognition of oncologic emergency must be done before referral to a tertiary referral hospital.

Platelet proteomic profiling in sitosterolemia suggests thrombocytopenia is driven by lipid disorder and not platelet aberrations

AbstractSitosterolemia is a rare autosomal recessive genetic disorder in which patients develop hypercholesterolemia and may exhibit abnormal hematologic and/or liver test results. In this disease, dysfunction of either ABCG5 or ABCG8 results in the intestinal hyperabsorption of all sterols, including cholesterol and, more specifically, plant sterols or xenosterols, as well as in the impaired ability to excrete xenosterols into the bile. It remains unknown how and why some patients develop hematologic abnormalities. Only a few unrelated patients with hematologic abnormalities at the time of diagnosis have been reported. Here, we report on 2 unrelated pedigrees who were believed to have chronic immune thrombocytopenia as their most prominent feature. Both consanguineous families showed recessive gene variants in ABCG5, which were associated with the disease by in silico protein structure analysis and clinical segregation. Hepatosplenomegaly was absent. Thrombopoietin levels and megakaryocyte numbers in the bone marrow were normal. Metabolic analysis confirmed the presence of strongly elevated plasma levels of xenosterols. Potential platelet proteomic aberrations were longitudinally assessed following dietary restrictions combined with administration of the sterol absorption inhibitor ezetimibe. No significant effects on platelet protein content before and after the onset of treatment were demonstrated. Although we cannot exclude that lipotoxicity has a direct and platelet-specific impact in patients with sitosterolemia, our data suggest that thrombocytopenia is neither caused by a lack of megakaryocytes nor driven by proteomic aberrations in the platelets themselves.

PERSIAN CAT WITH STAPHYLOCOCCUS SP. CYSTITIS

The vesica urinaria is inflamed in cystitis. The pH of the urine, the amount of food consumed, and bacterial infection are all factors that can contribute to infection and the production of uroliths. This article seeks to learn more about the procedures for diagnosing, managing, and treating feline cystitis problems. A male, black Persian cat with a body weight of 4.9 kg, two years old. With complaints of hematuria throughout the previous two days and complains of incontinence and inability to urinate with much volume. Urinary vesica wall thickening was discovered during ultrasound examination, along with urinary vesica crystals. Urinalysis, hematology testing, and urine culture were done. As a crystal breaker in the urinary vesica, ciprofloxacin dexamethasone and Batugin herbal medication were administered to the case animal. Change the cat diet and feed used for urinary care. One week after starting the therapy, the cat appeared in good health, peeing normally and without any signs of pain or blood. Based on macroscopic examination, the cat's urine was yellow and free of blood. The cat's urine was examined under a microscope, and no crystals were found. After seven days of medication, the case cat had positive effects. Smooth urination started, and there was no sign of stranguria, oliguria, or hematuria.

Therapeutic Potential of Coriander (Coriandrum sativum) Seeds Extract Treatment on Hematological and Biochemical Parameters in Healthy and Trichinella spiralis Infected Mice

The smallest known human nematode parasite is Trichinella spiralis (T. spiralis). A parasitic zoonosis that can be found anywhere in the world is trichinellosis. When a host consumes raw meat contaminated with Trichinella larvae, the larvae mature into adults in the host's stomach in 5 to 6 days. The females subsequently give birth to additional larvae, some of which eventually make it to muscle cells after travelling through blood channels. These cells allow infective larvae to survive for years because, after two to three weeks, the larvae become infectious and the host cell transforms into a nurse cell. The current study used parasitological assessment to count adult worms and encysted larvae at 5 weeks after infection (5WPI) to determine the effect of coriander seeds extract (CSE) against encysted larvae further to hematological and biochemical tests. Current results revealed that; Trichinella spiralis experimentally infection (5WPI) induced significant elevation in white blood cells (WBCs) counts, neutrophil, monocyte, eosinophil percentage, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), urea, creatinine and a significant depletion hemoglobin (Hb), red blood cell (RBC) count, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), platelet count (PLT), lymphocytes percentage, albumin, total proteins as compared to control and CSE groups. Meanwhile, treatments of 5WPI with CSE (5WPI+CSE) revealed a significant reduction in the number of Trichinella spiralis encysted larvae and improvements in all hematological parameters, liver and kidney functions as compared to 5WPI. We can conclude that; CSE could be an alternative method for treatment against trichinellosis.

Diagnostic Strategy for Suspected Unilateral Absence of the Pulmonary Artery.

To analyze the diagnostic strategy applied to seven patients with UAPA who were examined and subsequently treated at the National Lung Hospital, Hanoi, Vietnam. All seven patients, including three pediatric cases (1, 2, and 14 years old) and four adult cases (21, 26, 44, and 53 years old), had a history of recurrent pneumonia, and the clinical symptoms on admission included cough, progressive dyspnea, chest pain, and fatigue. The patients were initially examined clinically, followed by hematological testing, blood biochemistry testing, and chest X-ray radiology. The results suggested UAPA, so echocardiography and contrast-enhanced chest computed tomography (CT) were performed as soon as practical. The echocardiographic and CT imaging findings confirmed the suspected diagnosis of UAPA in all seven patients, which was accompanied by congenital heart disease in three patients. Three of the seven patients had mild and medium pulmonary hypertension. All seven patients were treated with drugs, which led to improvement in symptoms. Frontal chest X-ray provided the initial signs suggesting a diagnosis of UAPA. Subsequent echocardiography and contrast-enhanced chest CT were effective diagnostic tools for fast and accurate confirmation of UAPA.</p>.