Higher Hemoglobin Concentration Research Articles

Association Between Maternal Factors in Early Pregnancy and Congenital Heart Defects in Offspring: The Japan Environment and Children's Study.

Background Many prenatal factors are reported to be associated with congenital heart defects (CHD) in offspring. However, these associations have not been adequately examined using large-scale birth cohorts. Methods and Results We evaluated a data set of the Japan Environmental and Children's Study. The primary outcome was a diagnosis of CHD by age 2 years. We defined the following variables as exposures: maternal baseline characteristics, fertilization treatment, maternal history of diseases, socioeconomic status, maternal alcohol intake, smoking, tea consumption, maternal dietary intake, and maternal medications and supplements up to 12 weeks of gestation. We used multivariable logistic regression analysis to assess the associations between various exposures and CHD in offspring. A total of 91 664 singletons were included, among which 1264 (1.38%) had CHD. In multivariable analysis, vitamin A supplements (adjusted odds ratio [aOR], 5.78 [95% CI, 2.30-14.51]), maternal use of valproic acid (aOR, 4.86 [95% CI, 1.51-15.64]), maternal use of antihypertensive agents (aOR, 3.80 [95% CI, 1.74-8.29]), maternal age ≥40 years (aOR, 1.59 [95% CI, 1.14-2.20]), and high maternal hemoglobin concentration in the second trimester (aOR, 1.10 per g/dL [95% CI, 1.03-1.17]) were associated with CHD in offspring. Conclusions Using a Japanese large-scale birth cohort study, we found 6 maternal factors to be associated with CHD in offspring.

Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study

Anaemia in pregnancy is a global health problem with associated maternal and neonatal morbidity and mortality. We aimed to investigate the association between maternal haemoglobin concentrations during pregnancy and the risk of adverse maternal and neonatal outcomes. In this prospective, observational, multinational, INTERBIO-21st fetal study conducted at maternity units in Brazil, Kenya, Pakistan, South Africa, and the UK, we enrolled pregnant women (aged ≥18 years, BMI <35 kg/m2, natural conception, and singleton pregnancy) who initiated antenatal care before 14 weeks' gestation. At each 5±1 weekly visit until delivery, information was collected about the pregnancy, as well as the results of blood tests taken as part of routine antenatal care, including haemoglobin values. The outcome measures were maternal (gestational diabetes, pregnancy-induced hypertension, and preterm premature rupture of membranes) and neonatal outcomes (small for gestational age, preterm birth, and acute respiratory distress syndrome). Between Feb 8, 2012, and Nov 30, 2019, 2069 women (mean age 30·7 years [SD 5·0]) had at least one routinely haemoglobin concentration measured at 14-40 weeks' gestation, contributing 4690 haemoglobin measurements for the analysis. Compared with a haemoglobin cutoff of 110 g/L, the risk was increased more than two-fold for pregnancy-induced hypertension at haemoglobin concentrations of 170 g/L (risk ratio [RR] 2·29 [95% CI 1·19-4·39]) and higher, for preterm birth at haemoglobin concentrations of 70 g/L (RR 2·04 [95% CI 1·20-3·48]) and 165 g/L (RR 2·06 [95% CI 1·41-3·02]), and for acute respiratory distress syndrome at haemoglobin concentrations of 165 g/L (RR 2·84 [95% CI 1·51-5·35]). Trimester-specific results are also presented. Our data suggests that the current WHO haemoglobin cutoffs are associated with reduced risk of adverse maternal and neonatal outcomes. The current haemoglobin concentration cutoffs during pregnancy should not only consider thresholds for low haemoglobin concentrations that are associated with adverse outcomes but also define a threshold for high haemoglobin concentrations given the U-shaped relationship between haemoglobin concentration and adverse neonatal and maternal outcomes. Bill & Melinda Gates Foundation.

Comparative evaluation of clinical glycemic control markers treated with imeglimin and its effect on erythrocytes in patients with type 2 diabetes mellitus: study protocol of a single-arm, open-label, prospective, exploratory trial.

Background: Imeglimin is a novel type 2 diabetes (T2D) drug that is expected to improve mitochondrial function. In its phase 3 clinical trials in Japanese patients with T2D, the hemoglobin A1c (HbA1c) decrease following imeglimin administration was slow, reaching a plateau after 20-24weeks of treatment. In general, the erythrocyte lifespan may be a factor when HbA1c shows an abnormal value. Therefore, this study will comparatively evaluate HbA1c and other markers of glycemic control in patients with T2D after imeglimin administration and also examine the effects of imeglimin on erythrocytes. Methods: This single-arm, open-label, prospective, exploratory study is designed to evaluate the divergence between HbA1c and glycoalbumin (GA) or 1,5-anhydroglucitol (1,5-AG) and the glycemic reduction rate in 30 patients with T2D with inadequate glycemic control when imeglimin 2,000mg is administered for 6months. In addition, we will examine the effect on erythrocytes, the presumed cause of this divergence. We will measure sustained glycemic variability using flash glucose monitoring and examine the relationship between changes in these indices and HbA1c. Moreover, because prolonged erythrocyte lifespan is a possible cause of falsely high HbA1c levels, erythrocyte lifespan, erythrocyte deformability, and hemoglobin concentration will be evaluated as effects of imeglimin on erythrocytes. Furthermore, if imeglimin has an ameliorative effect on erythrocyte deformability, it may improve peripheral arterial disease; thus, we will also evaluate the toe-brachial pressure index, a measure of this effect. Discussion: In this study, if imeglimin administration results in diverging rates of hypoglycemic effect between HbA1c and GA or 1,5-AG and prolongs erythrocyte lifespan, GA and 1,5-AG, rather than HbA1c, will be considered appropriate measures of the hypoglycemic effect in the early stages of imeglimin administration. If imeglimin improves erythrocyte deformability, it may also be a new treatment strategy for peripheral arterial disease, a chronic complication of T2D. Ethics and dissemination: The study protocol was scientifically and ethically reviewed and approved by the Certified Clinical Research Review Board of Toho University (approval number: THU22002). The study protocol was registered in the Japan Registry of Clinical Trials (jRCT) in December 2022 (jRCTs031220489).

Hyper high haemoglobin content in red blood cells and erythropoietic transitions postnatally in infants of 22 to 26 weeks’ gestation: a prospective cohort study

ObjectiveBlood cell populations, including red blood cells (RBC) unique to the extremely preterm (EPT) infant, are potentially lost due to frequent clinical blood sampling during neonatal intensive care. Currently, neonatal...

Development of Iron Status Measures during Youth: Associations with Sex, Neighborhood Socioeconomic Status, Cognitive Performance, and Brain Structure

BackgroundIron is essential to brain function, and iron deficiency during youth may adversely impact neurodevelopment. Understanding the developmental time course of iron status and its association with neurocognitive functioning is important for identifying windows for intervention. ObjectivesThis study aimed to characterize developmental change in iron status and understand its association with cognitive performance and brain structure during adolescence using data from a large pediatric health network. MethodsThis study included a cross-sectional sample of 4899 participants (2178 males; aged 8–22 y at the time of participation, M [SD] = 14.24 [3.7]) who were recruited from the Children’s Hospital of Philadelphia network. Prospectively collected research data were enriched with electronic medical record data that included hematological measures related to iron status, including serum hemoglobin, ferritin, and transferrin (33,015 total samples). At the time of participation, cognitive performance was assessed using the Penn Computerized Neurocognitive Battery, and brain white matter integrity was assessed using diffusion-weighted MRI in a subset of individuals. ResultsDevelopmental trajectories were characterized for all metrics and revealed that sex differences emerged after menarche such that females had reduced iron status relative to males [all R2partial > 0.008; all false discovery rates (FDRs) < 0.05]. Higher socioeconomic status was associated with higher hemoglobin concentrations throughout development (R2partial = 0.005; FDR < 0.001), and the association was greatest during adolescence. Higher hemoglobin concentrations were associated with better cognitive performance during adolescence (R2partial = 0.02; FDR < 0.001) and mediated the association between sex and cognition (mediation effect = −0.107; 95% CI: −0.191, −0.02). Higher hemoglobin concentration was also associated with greater brain white matter integrity in the neuroimaging subsample (R2partial = 0.06, FDR = 0.028). ConclusionsIron status evolves during youth and is lowest in females and individuals of low socioeconomic status during adolescence. Diminished iron status during adolescence has consequences for neurocognition, suggesting that this critical period of neurodevelopment may be an important window for intervention that has the potential to reduce health disparities in at-risk populations.

Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes: an updated global systematic review and meta-analysis

BackgroundGrowing evidence suggests low and high maternal hemoglobin (Hb) concentrations may have adverse consequences for maternal and child health. There remain questions on specific Hb thresholds to define anemia and high Hb as well as how cutoffs may vary by anemia etiology and timing of assessment.MethodsWe conducted an updated systematic review (using PubMed and Cochrane Review) on low (< 110 g/L) and high (≥ 130 g/L) maternal Hb concentrations and associations with a range of maternal and infant health outcomes. We examined associations by timing of Hb assessment (preconception; first, second, and third trimesters, as well as at any time point in pregnancy), varying cutoffs used for defining low and high hemoglobin concentrations and performed stratified analyses by iron-deficiency anemia. We conducted meta-analyses to obtain odds ratios (OR) and 95% confidence intervals.ResultsThe updated systematic review included 148 studies. Low maternal Hb at any time point in pregnancy was associated with: low birthweight, LBW (OR (95% CI) 1.28 (1.22–1.35)), very low birthweight, VLBW (2.15 (1.47–3.13)), preterm birth, PTB (1.35 (1.29–1.42)), small-for-gestational age, SGA (1.11 (1.02–1.19)), stillbirth 1.43 (1.24–1.65)), perinatal mortality (1.75 (1.28–2.39)), neonatal mortality (1.25 (1.16–1.34), postpartum hemorrhage (1.69 (1.45–1.97)), transfusion (3.68 (2.58–5.26)), pre-eclampsia (1.57 (1.23–2.01)), and prenatal depression (1.44 (1.24–1.68)). For maternal mortality, the OR was higher for Hb < 90 (4.83 (2.17–10.74)) than for Hb < 100 (2.87 (1.08–7.67)). High maternal Hb was associated with: VLBW (1.35 (1.16–1.57)), PTB (1.12 (1.00-1.25)), SGA (1.17 (1.09–1.25)), stillbirth (1.32 (1.09–1.60)), maternal mortality (2.01 (1.12–3.61)), gestational diabetes (1.71 (1.19–2.46)), and pre-eclampsia (1.34 (1.16–1.56)). Stronger associations were noted earlier in pregnancy for low Hb and adverse birth outcomes while the role of timing of high Hb was inconsistent. Lower Hb cutoffs were associated with greater odds of poor outcomes; for high Hb, data were too limited to identify patterns. Information on anemia etiology was limited; relationships did not vary by iron-deficiency anemia.ConclusionBoth low and high maternal Hb concentrations during pregnancy are strong predictors of adverse maternal and infant health outcomes. Additional research is needed to establish healthy reference ranges and design effective interventions to optimize maternal Hb during pregnancy.

Re-analysis of the PolyHeme Phase III trial dataset: Lessons for future haemoglobin-based oxygen carrier trauma trials

IntroductionTo assist design of future HBOC clinical trials for pre-hospital and prolonged field care, the haemoglobin-based-oxygen carrier (HBOC) Phase III trauma trial database comparing PolyHeme to blood transfusion was re-analysed to identify causes of adverse early outcomes versus the 30-day mortality outcome of the original trial. We questioned if failure of PolyHeme (10 g/dl) to increase haemoglobin concentration and dilutional coagulopathy versus blood, caused higher Day 1 mortality in the PolyHeme arm of the trial. MethodsNew analyses of the original trial database, including Fisher's exact test, examined impact of interval changes in total haemoglobin [THb], coagulation, fluid volumes administered and mortality on Day 1 in the Control (pre-hospital crystalloids, then blood after trauma centre admission) and PolyHeme arms of the trial. ResultsAdmission [THb] was significantly greater (p<0.05) in PolyHeme (12.3 [SD = 1.8] g/dl) versus Control (11.5 [SD= 2.9] g/dl) patients. This early [THb] advantage was reversed within 6 h. Early mortality was negatively correlated with [THb] and maximum 1.4 h after hospital admission (17/365 for Control vs. 5/349 for PolyHeme). The mortality trend began reversing, when Control arm received blood. Coagulopathy was more common in the PolyHeme arm. Mortality rate was 2-fold greater for patients with coagulopathy in the control arm (18% vs. 9%, p = 0.1008) and 4-fold greater in PolyHeme arm (33% vs. 8.5%, p < 0.001). In a subgroup analysis of patients with major haemorrhage (n = 55), mortality was significantly higher in PolyHeme patients [12/26 (46.2%) versus 4/29 (13.8%) in control cohort (p = 0.018)], related to mean 10 liters more IV fluid administration and more severe anaemia (6.2 g/dL vs. 9.2 g/dL) in the PolyHeme cohort. ConclusionsPolyHeme (10 g/dL) diminished pre-hospital anaemia. The inability of PolyHeme to reverse acute anaemia in a subset of major haemorrhage patients was due to volume overload secondary to high PolyHeme doses, resulting in dilution of clotting factors and low circulating THb (versus transfused controls) during the first 12 h of the trial. Haemodilution was associated with prolonged administration of PolyHeme, while blood transfusion was available to Control patients following hospital admission. Coagulopathy exacerbated bleeding, anaemia, contributing to excess mortality in the PolyHeme arm. Future trials for prolonged field care should evaluate HBOC with higher haemoglobin concentration, lower volume administration and transition upon trauma centre admission to blood plus coagulation factors or whole blood.

Clinical features of multiple myeloma with bone plasmacytomas

Background . Multiple myeloma (MM) is a plasma cell tumour, which could be followed by formation of bone plasmacytomas. Bone plasmacytoma is plasma cells proliferate, developed in a medullar cavity, which could destroy cortical layer of a bone and escape to the surrounding tissues. Biological characteristics of tumour substrate hypothetically could influence the clinical course of MM. Aim . To compare clinical and laboratory parameters of newly diagnosed MM depending on the presence or absence of bone plasmacytomas. Materials and methods . A retrospective study included 40 patients with newly diagnosed MM aged from 24 to 63 years. 21 patients are diagnosed with bone plasmacytomas. In another 19 patients MM proceeded without plasmacytomas. As an induction therapy all patients were treated with bortezomib-containing regimens. 10 patients were also received immunomodulatory drugs. 34 patients underwent autologous hematopoietic stem cell transplantation (auto-HSCT). Results . When comparing laboratory parameters at the onset of MM, patients with bone plasmacytomas showed minor lesion of bone marrow, higher haemoglobin concentration and low paraprotein secretion. When comparing MM clinical parameters it turned out that the frequency of achieving a significant antitumor response after induction therapy was reliably lower in patients with bone plasmacytomas: 28.6 % versus 68.4 % (p = 0.038). Auto-HSCT made it possible to deepen the antitumor response in group of patients with bone plasmacytomas. On +100 day auto-HSCT significant antitumor response was registered in 52.6 % of patients. For correct assessment of antitumor response the dynamics of plasmacytoma measurements is very important. When using only the data of immunochemical analysis for response assessment, the frequency of achieving a significant antitumor response is overestimated, this is not an adequate reflection of clinical situation. Conclusion . MM with bone plasmacytomas has some clinical and laboratory features. Auto-HSCT is highly efficient method of treatment of this patient cohort. Assessment of antitumor response in patients with bone plasmacytomas only by the data of immunochemical analysis is insufficient and may serve as a reason for choosing the wrong therapeutical tactics.

Anemia in pregnancy and sleep of 6-month-old infants: A prospective cohort study.

Anemia has been reported to adversely influence sleep in infants. However, the association between anemia in pregnancy and infant sleep remains unclear. We aimed to examine the association between maternal anemia in pregnancy and sleep parameters of 6-month-old infants. We enrolled 2,410 mother-infant pairs between 2018 and 2021 in Hefei. Data on maternal hemoglobin concentration were collected at 24-28 gestational weeks from the electronic medical records of the hospitals. Nocturnal and daytime sleep duration, number of night awakenings, nocturnal wakefulness, and sleep latency of infants aged 6 months were measured using the Brief Infant Sleep Questionnaire with five items. A restricted cubic spline model was used to examine the relationship between maternal hemoglobin concentration and infant nocturnal sleep duration after adjusting for potential confounders. In our study, 807 (33.5%) mothers had anemia during pregnancy. Compared to infants born to mothers without anemia, infants born to mothers with anemia in pregnancy had shorter nocturnal sleep duration [mean (SD), 560.29 (79.57) mins vs. 574.27 (75.36) mins] at the age of 6 months. Subgroup analysis showed consistent significant differences in nocturnal sleep duration between infant born to anemic and non-anemic mothers, except in case of stratification by preterm birth [mean difference (mins), 2.03 (95% CI, -20.01, -24.07)] and pre-pregnancy obesity [mean difference (mins), -0.85 (95% CI, -16.86, -15.16)]. A J-shaped nonlinear correlation curve was observed between maternal hemoglobin concentration and infant nocturnal sleep duration. Compared with mothers without daily iron supplementation, mothers who had daily iron supplementation had higher hemoglobin concentrations [mean (SD), 112.39 (11.33) g/L vs. 110.66 (10.65) g/L] at delivery and their infants had longer nocturnal sleep duration [mean (SD), 565.99 (82.46) mins vs. 553.66 (76.03) mins]. Anemia in pregnancy may have an adverse influence on the sleep of 6-mon-old infants, and the relationship between maternal hemoglobin concentration and nocturnal sleep duration is nonlinear.

Excessive Erythrocytosis Is Not Associated With Altered Iron Homeostasis in Men From the World's Highest City.

Excessive Erythrocytosis Is Not Associated With Altered Iron Homeostasis in Men From the World's Highest City.

The effects of oral ferrous bisglycinate supplementation on hemoglobin and ferritin concentrations in adults and children: a systematic review and meta-analysis of randomized controlled trials.

Iron deficiency and anemia have serious consequences, especially for children and pregnant women. Iron salts are commonly provided as oral supplements to prevent and treat iron deficiency, despite poor bioavailability and frequently reported adverse side effects. Ferrous bisglycinate is a novel amino acid iron chelate that is thought to be more bioavailable and associated with fewer gastrointestinal (GI) adverse events as compared with iron salts. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effects of ferrous bisglycinate supplementation compared with other iron supplements on hemoglobin and ferritin concentrations and GI adverse events. A systematic search of electronic databases and grey literature was performed up to July 17, 2020, yielding 17 RCTs that reported hemoglobin or ferritin concentrations following at least 4 weeks' supplementation of ferrous bisglycinate compared with other iron supplements in any dose or frequency. Random-effects meta-analyses were conducted among trials of pregnant women (n = 9) and children (n = 4); pooled estimates were expressed as standardized mean differences (SMDs). Incidence rate ratios (IRRs) were estimated for GI adverse events, using Poisson generalized linear mixed-effects models. The remaining trials in other populations (n = 4; men and nonpregnant women) were qualitatively evaluated. Compared with other iron supplements, supplementation with ferrous bisglycinate for 4-20 weeks resulted in higher hemoglobin concentrations in pregnant women (SMD, 0.54 g/dL; 95% confidence interval [CI], 0.15-0.94; P < 0.01) and fewer reported GI adverse events (IRR, 0.36; 95%CI, 0.17-0.76; P < 0.01). We observed a non-significant trend for higher ferritin concentrations in pregnant women supplemented with ferrous bisglycinate. No significant differences in hemoglobin or ferritin concentrations were detected among children. Ferrous bisglycinate shows some benefit over other iron supplements in increasing hemoglobin concentration and reducing GI adverse events among pregnant women. More trials are needed to assess the efficacy of ferrous bisglycinate against other iron supplements in other populations. CRD42020196984.

Pumpkin seed oil–supplemented diets promoted the growth productivity, antioxidative capacity, and immune response in heat-stressed growing rabbits

Heat stress is the most major environmental element contributing to rabbit health problems and reduced production. It is proposed that essential oils be applied to alleviate heat stress-induced oxidative damage in rabbits. The purpose of this feeding trial was to determine the protective impact of pumpkin seed essential oil (PSO)–supplemented diets in reducing the threat of unambient temperature on growing rabbits. Five groups of 5-week-old rabbits were allocated randomly into separated galvanized wire battery. The first group was raised under normal conditions (18 ± 2 °C) and fed a control diet (control group; CNT), whereas the other four groups were exposed to high ambient temperature (38 ± 2 °C) and fed a control diet supplemented with 0 (PSO0.0), 0.5 (PSO0.05), 1.0 (PSO1.0), and 2.0 (PSO2.0) mL PSO/kg diet. Results indicated that all supplemented groups and the positive control have higher live body weight compared with the heat stress group (PSO0.0) at 9 weeks of age. Supplementing of PSO resulted in significant improvement in weight gain at 5–9 weeks and 9–13 weeks compared with PSO0.0 group. The highest feed intake was detected in PSO0.05 group compared with that in other groups. Both PSO2.0 and PSO2.0 groups showed the lowest feed conversion ration compared with other groups. Heat-stressed rabbits given a high dose of PSO (1 to 2 mL) had higher hemoglobin concentrations and lower white blood cell counts throughout the experiment than those given a control diet and subjected to heat stress. All hepatic and renal function parameters improved significantly in the rabbits fed a high dose of PSO as compared to the heat-stressed control group, while protein constituents were significantly higher in experimental groups fed 2 mL PSO compared with other groups. Heat-stressed rabbits administered graded amounts of PSO had the lowest plasma glucose, cortisol, thyroid, and corticosterone concentrations and were noticed to be equivalent to the control group fed unsupplemented diet and reared under normal conditions. The immunohistochemistry analysis demonstrated that rabbit groups reared under heat stress and given 2 mL PSO supplemented diets had negative caspase-3 immunoreactivity surrounding portal tract and normal structure. In conclusion, adding pumpkin seed oil up to 2 mL/kg diet for growing rabbits is indorsed to promote growth as well as antioxidant and immunological status under heat stress conditions.

Phytoradiotherapy to enhance cancer treatment outcomes with cannabidiol, bitter melon juice, and plant hemoglobin.

Despite technological advances in radiation therapy for cancer treatment, many patient populations still experience mediocre survival percentages, local control, and quality of life. Additionally, much of the world lacks access to expensive, modern treatment options. The need for innovative, cost-effective solutions that can improve patient treatment outcomes is essential. Phytomedicines have been shown to induce apoptotic tumor cell death, diminish tumor progression, reduce cancer incidence, alleviate harmful hypoxic conditions, and more. While an ample amount of research is available that characterizes many phytomedicines as having anti-cancer properties that increase tumor cell killing/control and mitigate the harmful side effects of radiation damage, little work has been done to investigate the synergistic effect of phytoradiotherapy: combining radiation treatment with phytomedicines. In this study, a protocol for testing the radiosensitizing effects of phytomedicines was validated and used to investigate the well-known plant based medicine cannabidiol (CBD) and the lesser-known medicinal fruit Bitter Melon. Additionally, based on its high concentration of plant hemoglobin which has been shown to abate hypoxia, the African-indigenous Justicia plant was tested in pancreatic adenocarcinoma mouse models. The studies reveal that these phytomedicines can effectively enhance tumor cell killing, minimize tumor growth, and prolong mice survival. There is certainly the need for additional research in this regard, however, phytoradiotherapy: the use of phytomedicines to enhance radiation therapy treatment outcomes, continues to show potential as a promising, innovative way to improve cancer care.

Prevalence of malaria and associated clinical manifestations and myeloperoxidase amongst populations living in different altitudes of Mezam division, North West Region, Cameroon

BackgroundMalaria is a growing problem in Africa, with prevalence varies from areas to areas due to several factors including the altitude. This study aimed to investigate the malaria distribution and its relationship with level of some blood parameters and plasma myeloperoxidase (MPO) in population of three localities with different altitudes.MethodsA total of 150 participants were recruited in each locality and facial body temperature of each was measured using a forehead digital thermometer. Blood samples were collected and used diagnose malaria parasite using the rapid test followed by Giemsa stain microscopy and have the full blood count and MPO level using a colorimetric method.ResultsThe overall prevalence of falciparum malaria was 34.7%, with no difference between the three communities, but Bambili of high altitude had the highest prevalence (70.7%). A majority of the infected persons had mild malaria, with most cases being asymptomatic (temperature < 37.5 ºC). Patients had significant increase of geometric mean malaria parasite density (GMPD) in Bambili (1755 ± 216 parasites/µL) and Bamenda (1060 ± 2515 parasites/µL of blood) than patients in Santa (737 ± 799 parasites/µL). There was a significant risk to have malaria infection in Bambili (OR = 33.367, p = 0.021) than in Santa (OR = 2.309, p = 0.362). Bambili’ participants of 6–10 years showed a high prevalence of malaria (85.7%). GMPD was significantly different between males (p = 0.010) as well as females (p = 0.000). Participants from Santa (11.2 ± 3.2 g/dL) and Bambili (12.6 ± 2.4 g/dL) had a high haemoglobin concentration than those from Bamenda (10.6 ± 2.1 g/dL). There was a significant difference in the WBC counts and platelet counts among infected participants in the study areas. MPO level had an increasing trend among infected participants in Santa (2.378 ± 0.250), Bambili (2.582 ± 0.482) and Bamenda (2.635 ± 0.466).ConclusionThe results of the present study demonstrated that altitudinal variations significant impact the risk of population to have malaria with high parasitaemia and may contribute to the malaria prevalence and severity by affecting the haemoglobin concentration, WBC and platelet level and plasma MPO in population.

Effect of inclusion of fish protein hydrolysate in diet for european whitefish (coregonus lavaretus linnaeus, 1758) juveniles on their hematological parameters

Prior studies have measured the effects on the Growth and Survival of supplementing fish diets with fish protein hydrolysate (FPH) as an alternative protein source. Initial results have suggested a positive impact on fish health and this study aimed to investigate specifically the impact of a 5% substitution of FPH on European Whitefish juveniles hematological parameters. A 56-day manual feeding trial was conducted on two triplicate groups of 500 fish, consulting of a control diet group and 5% FPH diet group. A feeding rate of 3% of total biomass was applied with feeding being carried out three times a day. The higher concentration of hemoglobin (60.73±3.55 g/L vs. 51.47±2.52 g/L), color index (1.62±0.15 vs. 1.23±0,07) and mean corpuscular hemoglobin (56.64±3.49 g/L vs. 45.75±2.11 g/L), as well as the lower level of oxyphilic normoblasts (1.33±0.26 % vs. 2.08±0.32 %) in the blood of fish in the experimental group, indicate active metabolic processes occurring in their bodies and better oxygen supply to their tissues. The significantly higher concentration of total protein in the blood serum (48.29±1.48 g/L vs. 35.35±1.43 g/L) of this group of fish suggests better food assimilation in their organism. The hematological data obtained during the study indicate the positive influence of the fish protein hydrolysate on the fish organism.

Antimalarial Efficacy and Safety of Senna occidentalis (L.) Link Root Extract in Plasmodium berghei-Infected BALB/c Mice.

Emergence of Plasmodium resistance to antimalarial drugs presents a major drawback in efforts to control malaria. To address this problem, there is an urgent and continuous need for the development of new and effective antimalarial agents. Senna occidentalis (L.) link extract has exhibited in vitro antiplasmodial activity in many pharmacological studies. To our knowledge, data on its in vivo antimalarial efficacy is still very limited. A recent study demonstrated that polar extracts from the plant roots inhibit Plasmodium berghei proliferation in a mouse model. This study further describes the efficacy and safety of a methanolic root extract of the plant as an antimalarial agent by demonstrating its effect on hematological, biochemical, and histological parameters of Plasmodium berghei-infected BALB/c mice. Rane's test, a curative approach, was used to evaluate the antimalarial efficacy of Senna occidentalis methanolic root extract in Plasmodium berghei-infected BALB/c mice. The effect of the extract on both hematological and biochemical parameters was evaluated using automated analyzers. Kidney, liver, lung, spleen, and brain tissues were harvested from euthanized mice and examined for changes in organ architecture. This study demonstrates that methanolic root extract of Senna occidentalis significantly inhibited Plasmodium berghei parasitemia in BALB/c mice (p < 0.01). Infected mice that were treated with the extract depicted a significantly low level of total leucocytes (p < 0.01), red blood cell distribution width (p < 0.01), and a significantly high hemoglobin concentration (p < 0.001) compared to the infected animals that were administered with the vehicle only. The infected animals that were treated with the extract exhibited a significantly low level of urea, creatinine, bilirubin, and alkaline phosphatase (p < 0.05), compared to the infected animals that were given the vehicle only. The level of sodium, potassium and chloride ions, lymphocytes, granulocytes, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration, total protein, albumin, aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total platelets, mean platelet volume (MPV), and platelet distribution width of the infected animals treated with the extract was not significantly different from those of the infected animals that were given the vehicle only (p > 0.05). The extract alleviated organ pathological changes in the infected mice. The extract did not induce any remarkable adverse effect on the growth, hematological, and biochemical parameters of uninfected animals (p > 0.05). In addition, administration of the extract did not alter the gross appearance and histological architecture of the organs, implying that the extract was well tolerated in mice. Senna occidentalis methanolic root extract exhibited good antimalarial activity against Plasmodium berghei and may be safe in mice.

Maternal hemoglobin and risk of low birth weight: A hospital-based cross-sectional study in Nepal

BackgroundMaternal hemoglobin during pregnancy is an important predictor of neonatal outcomes such as birth weight. The newborn weight of an infant is considered a crucial factor for morbidity and mortality. This study aimed to assess the association between maternal hemoglobin concentration and newborn weight at term pregnancy. MethodsA hospital-based cross-sectional study was conducted at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from 14th April 2018 to 13th April 2019. Term singleton pregnant women who were admitted for delivery in the labor room of TUTH were included in this study. Maternal characteristics such as age, parity, birth space, ethnicity, education level, dietary habit, body mass index (BMI), and hemoglobin level were recorded. The newborn weight was taken immediately after delivery. The main outcome of this study was the birth weight. The association between hemoglobin level and newborn weight was analyzed using bivariate and multivariable logistic regression analysis. ResultsOf 2,418 term pregnant women, the prevalence of low hemoglobin and high hemoglobin levels were 24% (95% CI: 22–25.4), and 17% (95% CI: 15.7–18.7), respectively. The prevalence of low birth weight (LBW) was 12.9% (95% CI: 11.7–14.4). Multivariable logistic regression analysis showed that those mothers who had low hemoglobin concentration (adjusted Odds Ratio/aOR = 3.77, 95% CI: 2.84–5.01), and high hemoglobin concentration (aOR = 3.07, 95% CI: 2.23–4.24) had higher odds of having LBW compared to mothers having normal hemoglobin level. Mothers with both young age pregnancy (aged 16–20 years) and older pregnancy (aged ≥31 years) (aOR = 1.60, 95% CI: 1.01–2.52) and (aOR = 1.60, 95% CI: 1.06–2.41), respectively had higher odds of LBW compared to mothers aged 21–25 years. Those mothers who attended a primary level of education had higher odds of (aOR = 1.93, 95% CI: 1.05–3.55) LBW compared to those mothers with a higher level of education. Moreover, mothers who belonged to Janajati ethnic group (aOR = 0.47, 95% CI: 0.34–0.65) compared to the Brahmin/Chhetri ethnic group, and mothers with a birth space of more than three years (aOR = 0.63, 95% CI: 0.41–0.97) compared to those who had less than three years of birth spacing and mothers who were overweight/obese (aOR = 0.74, 95% CI: 0.55–0.99) compared to normal nutritional status had lower odds of having LBW. ConclusionsOur study concludes that both low and high hemoglobin had an increased risk of having low birth weight. Policies and programs can benefit by adopting the findings of this study. More empirical research is critical to understanding the impact of hemoglobin levels on birth weight.

Clinical Parameters and Mortality in COVID-19 Patients Admitted to an Intensive Care Unit (ICU) in Qazvin City

Background: The initial reports of an outbreak of SARS-CoV-2 pneumonia suggest that COVID-19 is a severe disease. Objective: We aimed to investigate the clinical parameters and mortality of patients with SARS-CoV-2 pneumonia admitted to the intensive care unit (ICU) of Velayat Hospital in Qazvin, Iran. Methods: In this single-centered, cross-sectional, and retrospective study, we enrolled all adult patients with COVID-19 admitted to the intensive care unit (ICU) of Velayat Hospital from March 20 to April 30, 2020. Sociodemographic data, laboratory values, and disease outcomes of the patients were collected. Then, the obtained data were compared between survivors and non-survivors. Results: Of 1100 patients with SARS-CoV-2 pneumonia, 74 adult patients were included in this study. The Mean±SD age of the 52 patients was 60.1±16.46 years. All patients had underlying diseases. The Mean±SD time from admission to discharge from the ICU was 12.39±6.48 days. The logistic regression test indicated that the amount of blood urea nitrogen (BUN) during hospitalization in the ICU was associated with increased mortality risk (OR=1.081, 95% CI=1.024-1.141; P=0.005). Moreover, the same test showed that platelet count (OR: 0.991, 95% CI: 0.985-0.997; P=0.002) and hemoglobin concentration (OR: 0.691, 95% CI: 0.502-0.951; P=0.023) were associated with a decreased mortality risk in ICU patients; this means that patients with higher hemoglobin concentration and platelet counts had a lower mortality risk in ICU. Conclusion: The mortality rate of patients with SARS-CoV-2 pneumonia is high. The BUN level was a predictor of mortality in patients with COVID-19. Therefore, it is recommended that BUN be measured during initial referral, and based on that, timely and appropriate corrective actions be conducted.

РЕСПИРАТОРНЫЕ СВОЙСТВА КРОВИ PLANILIZA HAEMATOCHEILUS (TEMMINCK &amp; SCHLEGEL, 1845) И ZOSTERISESSOR OPHIOCEPHALUS (PALLAS, 1814)

The natural mobility of the organisms affects the functional state and development of many organ systems and tissues. It influences, first of all, oxygen supply systems: respiratory, circulatory, blood. Of particular interest are molecular complexes whose functional characteristics are determined at the genetic level. These include respiratory pigments, hemoglobin in particular, to which this work is devoted. The gas transport properties of the blood of a highly mobile mullet-pilengas (Planiliza haematocheilus) and a sedentary bottom species – grass goby (Zosterisessor ophiocephalus) were studied. Blood was obtained by puncture of the caudal artery. Heparin was used as an anticoagulant. Pilengas' blood had a higher concentration of hemoglobin and the number of red blood cells. The differences in hemoglobin were almost 40% (p &lt;0.01), in erythrocytes about 2 times (p &lt;0.01) (p &lt;0.001). With respect to the mean cell hemoglobin content (MCN), the results were the opposite. Pilengas' blood was characterized by low affinity for oxygen and increased sensitivity to pH. The value of P50 and the values of the Born effect (r) in pilengas were 25-26% (p &lt;0.01) and 2.7-2.8 times (p &lt;0.001), respectively, higher than in grass goby. The values of the Hill coefficient (n), intracellular concentrations of nucleotide triphosphates and Cl- coincided in both species. The differences obtained reflect the process of adaptation of the pilengas organism to a highly mobile lifestyle.

Molecular Profiles and Clinical Features of Myeloproliferative Neoplasms Unclassifiable (MPN-U) with and without JAK2/CALR/MPL Mutations

Introduction: Myeloproliferative neoplasms (MPNs) are clonal hematopoietic neoplasms and include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), etc., each with specific diagnostic criteria. Patients who display features compatible with MPN but do not meet the diagnostic criteria for a specific entity are commonly assigned a diagnosis of MPN, unclassifiable (MPN-U). JAK2, CALR, and MPL are well-known driver mutations in PV, ET, and PMF. With the advancement and application of next-generation sequencing (NGS), the molecular profiles of the above 3 well-defined MPNs have been extensively studied. However, the molecular profile of MPN-U remains ill-defined. In this study, we aimed to describe the clinical and molecular features of MPN-U in our institution and then compare these features between patients with and without JAK2, CALR, or MPL mutations to better understand the clinicopathologic characteristics and prognosis of MPN-U. Method: The patients with a diagnosis of MPN-U and available NGS test results at our cancer center were identified and divided into two groups: cohort A) MPN-U with mutations in JAK2, CALR, or MPL, and cohort B) triple-negative. The patients' survival data, clinical parameters, bone marrow findings, and cytogenetics were collected for comparison. Baseline characteristics and somatic mutation distributions were compared using the chi-square test (categorical variables) and Wilcoxon rank sum test (continuous variables). Overall survival (OS) was calculated using the Kaplan-Meier method and compared using the log-rank test. A Cox proportional-hazards model was used to evaluate the association between OS and clinical factors. Results: Out of 8285 patients in our institutional clinical molecular database which houses NGS, we identified and confirmed MPN-U diagnosis in 53 patients. Among this group, 39 patients harbored JAK2 (n=36), CALR (n=1), MPL (n=1), or JAK2 and CALR co-mutations (n=1) and were assigned to cohort A. The remaining 14 patients were triple-negative and assigned to cohort B. The triple-negative patients in cohort B had higher median WBC count (18.5 x 10 9/L vs 9.98 x 10 9/L, p=0.04) and bone marrow cellularity (81% vs 64%, p=0.02) (Table 1). The mutational profile of cohort B was enriched for CUX1, ETV6, NRAS, SETBP1, and SRSF2 mutations. ASXL1 and SETBP1 were the most frequently mutated genes in the triple-negative group, and were often co-mutated with ETV6, NRAS, and/or SRSF2 (Figure 1). TET2 mutations appeared more common in cohort A, but this finding was not statistically significant. There were no significant differences in the other parameters, including gender, bone marrow blast percentage, karyotype, hemoglobin concentration, platelet count, and bone marrow fibrosis. Kaplan-Meier analysis demonstrated that the median OS time in cohorts A and B was not reached, and survival differences were not statistically significant (p-value 0.23). We used a Cox proportional-hazards model to evaluate the association between OS and clinical factors. Via backward elimination, we uncovered that high WBC count and low hemoglobin concentration were significantly associated with worse outcome (hazard ratios of 1.04 and 1.33, respectively, and p-values of 0.007 and 0.01). Conclusion: In our small cohort, the patients with MPN-U who were triple-negative for JAK2,CALR, and MPL mutations had more frequent CUX1, ETV6, NRAS, SETBP1, and SRSF2 mutations. ASXL1 and SETBP1 were the most frequently mutated genes in the triple-negative group, and were often co-mutated with ETV6, NRAS, and/or SRSF2. In addition, triple-negative patients had higher WBC counts and higher bone marrow cellularity. A Cox proportional-hazards model identified high WBC count and low hemoglobin concentration as being significantly associated with a worse outcome. Kaplan-Meier analysis did not reveal a difference in OS between triple-negative and JAK2, CALR, or MPL mutated MPN-U. A larger cohort is needed to evaluate the survival outcome of these two distinct groups. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal