Increase In Mean Corpuscular Volume Research Articles

Hyaluronic acid impacts hematological endpoints and spleen histological features in African catfish (Clarias gariepinus)

Since its identification in the vitreous humour of the eye and laboratory biosynthesis, hyaluronic acid (HA) has been a vital component in several pharmaceutical, nutritional, medicinal, and cosmetic uses. However, little is known about its potential toxicological impacts on aquatic inhabitants. Herein, we investigated the hematological response of Clarias gariepinus to nominal doses of HA. To achieve this objective, 72 adult fish were randomly and evenly distributed into four groups: control, low-dose (0.5 mg/l HA), medium-dose (10 mg/l HA), and high-dose (100 mg/l HA) groups for two weeks each during both the exposure and recovery periods. The findings confirmed presence of anemia, neutrophilia, leucopoenia, lymphopenia, and eosinophilia at the end of exposure to HA. In addition, poikilocytosis and a variety of cytomorphological disturbances were observed. Dose-dependent histological alterations in spleen morphology were observed in the exposed groups. After HA removal from the aquarium for 2 weeks, the groups exposed to the two highest doses still exhibited a notable decline in red blood cell count, hemoglobin concentration, mean corpuscular hemoglobin concentration, and an increase in mean corpuscular volume. Additionally, there was a significant rise in neutrophils, eosinophils, cell alterations, and nuclear abnormalities percentages, along with a decrease in monocytes, coupled with a dose-dependent decrease in lymphocytes. Furthermore, only the highest dose of HA in the recovered groups continued to cause a significant increase in white blood cells. White blood cells remained lower, and the proportion of apoptotic RBCs remained higher in the high-dose group. The persistence of most of the haematological and histological disorders even after recovery period indicates a failure of physiological compensatory mechanisms to overcome the HA-associated problems or insufficient duration of recovery. Thus, these findings encourage the inclusion of this new hazardous agent in the biomonitoring program and provide a specific pattern of hematological profile in HA-challenged fish. Further experiments are highly warranted to explore other toxicological hazards of HA using dose/time window protocols.

CDK4/6 Inhibitor-Associated Mean Corpuscular Volume Change: A Potential Parameter for Predicting Survival in Metastatic Breast Cancer?

To evaluate the impact of CDK4/6 inhibitors on erythrocyte mean corpuscular volume (MCV) change and its possible correlation with progression-free survival (PFS) and overall survival (OS). Observational study. Place and Duration of the Study: Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkiye, between January 2020 and 2023. The data of 74 patients with HR (+) HER2 (-) metastatic breast cancer were analysed retrospectively. MCV and other complete blood count metrics were noted before and after the treatment. The first post-treatment evaluation was performed at three months. The median ΔMCV values at the third month after treatment-baseline were calculated. The patients were all females, with a median age of 55 years (between 35 and 80). Prior to the therapy, the baseline median MCV level was 90.4 (min-max: 77.3-113.2). After three months, the median MCV level was 95 (min-max: 84.3-115.3). Moreover, 7.15 was the median ΔMCV level. Regarding PFS (16.53 vs. 15.26 months) (p = 0.13) and OS (21.46 vs. 17.83 months) (p = 0.08), there was no statistically significant difference seen between the group with ΔMCV ≥7.15 and the group with ΔMCV <7.15. CDK4/6 inhibitors led to an increase in MCV but there was no significant difference between PFS or OS and the increase in MCV. To figure out whether the rise in MCV represents a prognostic or predictive marker, further research is required. Breast cancer, CDK4/6 inhibitors, Mean corpuscular volume, Prognosis.

Intermittent hypoxia training does not change erythrocyte aggregation indicators in young, healthy men.

The increasing popularity of hypoxic training as a training method to improve physical performance indicates the need to study the effects of this type of intervention on blood morphological and rheological indices, since the adaptive changes that follow such training mainly affect blood indices. In this study, the effects of a 4weeks of intermittent hypoxic training on blood morphological and rheological indicators in physically active men were assessed. Forty-eight young, physically active men, participated in the study. Participants were randomly divided into three groups: two training groups and a control group without intervention (CTRL). Each group consisted of 16 participants. Training groups performed interval training (three times per week, 4weeks, 12 workouts) under different conditions: in hypoxia (IHT; fraction of inspired oxygen (FiO2) = 14.4%) or in normoxia (NT; FiO2 = 20.9%). The control group performed only two workouts 4weeks apart. Blood was taken during the first and last training session at rest, and 3minutes after training. After the last training session, there was a significant increase in mean corpuscular volume and a decrease in mean corpuscular haemoglobin concentration measured at rest only in the IHT group. There was also a significant decrease in resting aggregation amplitude for the IHT and CTRL groups. There was no difference in change of post-exercise plasma volume between first and last training session. The applied intermittent interval training in conditions of normoxia and hypoxia had no significant impact on resting aggregation parameters. This suggest that training under hypoxic conditions does not cause adverse rheological changes.

Assessing mean corpuscular volume as a screening tool for gestational vitamin B12 deficiency based on NHANES.

Vitamin B12 can lead to neurological deficits. We assessed whether the mean corpuscular volume (MCV) could be a sufficiently sensitive measurement for abnormal serum methylmalonic Acid (MMA) and total plasma homocysteine (tHCY) (biomarkers of vitamin B12 or folate deficiency) and if so, at what cutoff value. A total of 26,397 participants (12,730 males and 13,667 females) were included in the analysis. Weighted analysis was performed using NHANES data to calculate crude/adjusted associations between MCV-MMA/tHCY, using linear regression. Unadjusted odds ratios (OR) 95% CIs were estimated from logistic regression models. Receiver Operating Curve and the Youden Index were used to identify the MCV level that most accurately distinguished those with abnormal MMA and tHCY (dependent variables) from those without. A positive and significant correlation between MCV-MMA/tHCY was found in the general population between ages 18-85, 0.95 (95% C.I. 0.75-1.17) and 2.61 (95% C.I. 2.15-3.08). In pregnant women, for every unit increase in MCV there was a 19% increase in odds of abnormal MMA, OR 1.19 (95% C.I. 1.08-1.31), p=0.001 and the Area Under the Curve for MCV as a test for abnormal MMA was 78%. An MCV cutoff of 93.1 correctly identified abnormal MMA in pregnant women with 81% sensitivity and 77% specificity. In the general population the MCV test performed poorly in identifying abnormal MMA/tHCY. MCV is an inexpensive measurement that may be useful to screen asymptomatic pregnant women for vitamin B12 abnormalities. This may have a significant impact on reducing adverse neurological outcomes in their children.

Mentha piperita and Thymus vulgaris ameliorate hematological changes induced by chronic consumption of oxidized palm oil in rats

Objective: The aim of this study was to investigate the effect of Mentha piperita L and/or Thymus vulgaris in ameliorating the hematological changes induced by chronic consumption of oxidized palm oil (OPO) in rats. Methodology: Fifty rats were divided into five groups as follows: rats received a basal diet (control), rats received a basal diet sustained with OPO, rats fed OPO and received Mentha piperita extract, rats fed OPO and received Thymus vulgaris extract, and finally rats fed OPO and received both extracts. After 6 weeks, blood samples were withdrawn and a complete blood count test was done. Results: Rats fed a diet containing OPO showed a significant decrease in red blood cells (RBCs), hematocrit (Hct), mean corpuscular volume (MCV), hemoglobin (Hb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), lymphocytes (LYM), and platelets (PLTs) accompanied by a significant increase in white blood cells (WBCs), red cell distribution width (RDW), and mean platelet volume (MPV) compared to rats fed a normal diet. In contrast, rats fed on diet containing OPO and the aqueous extract of either Mentha piperita or Thymus vulgaris showed a significant increase in RBCs, Hct, MCV, Hb, MCH, MCHC, LYM, and PLTs accompanied by a significant decrease in RDW, WBCs, and MPV relative to rats fed on diet containing OPO only. Treatment with a combination of both plants showed better improvements. Conclusion: Both Mentha piperita and Thymus vulgaris ameliorate the hematological changes induced by OPO.

Exploring hematological alterations and genetics linked to SNV rs10974944 in myeloproliferative neoplasms among Amazon patients

BCR::ABL1-negative myeloproliferative neoplasms are hematopoietic disorders characterized by panmyelosis. JAK2 V617F is a frequent variant in these diseases and often occurs in the 46/1 haplotype. The G allele of rs10974944 has been shown to be associated with this variant, specifically its acquisition, correlations with familial cases, and laboratory alterations. This study evaluated the association between the 46/1 haplotype and JAK2 V617F in patients with myeloproliferative neoplasms in a population from the Brazilian Amazon. Clinical, laboratory and molecular sequencing analyses were considered. Carriers of the G allele of rs10974944 with polycythemia vera showed an increase in mean corpuscular volume and mean corpuscular hemoglobin, while in those with essential thrombocythemia, there was an elevation in red blood cells, hematocrit, and hemoglobin. Associations were observed between rs10974944 and the JAK2 V617F, in which the G allele (OR 3.4; p < 0.0001) and GG genotype (OR 4.9; p = 0.0016) were associated with JAK2 V617F + and an increase in variant allele frequency (GG: OR 15.8; p = < 0.0001; G: OR 6.0; p = 0.0002). These results suggest an association between rs10974944 (G) and a status for JAK2 V617F, JAK2 V617F + _VAF ≥ 50%, and laboratory alterations in the erythroid lineage.

Environmental chemical-wide associations with immune biomarkers in US adults: A cross-sectional analysis

Environmental chemical exposures influence immune system functions, and humans are exposed to a wide range of chemicals, termed the chemical “exposome”. A comprehensive, discovery analysis of the associations of multiple chemical families with immune biomarkers is needed. In this study, we tested the associations between environmental chemical concentrations and immune biomarkers. We analyzed the United States cross-sectional National Health and Nutrition Examination Survey (NHANES, 1999–2018). Chemical biomarker concentrations were measured in blood or urine (196 chemicals, 17 chemical families). Immune biomarkers included counts of lymphocytes, neutrophils, monocytes, basophils, eosinophils, red blood cells, white blood cells, and mean corpuscular volume. We conducted separate survey-weighted, multivariable linear regressions of each log2-transformed chemical and immune measure, adjusted for relevant covariates. We accounted for multiple comparisons using a false discovery rate (FDR). Among 45,528 adult participants, the mean age was 45.7 years, 51.4% were female, and 69.3% were Non-Hispanic White. 71 (36.2%) chemicals were associated with at least one of the eight immune biomarkers. The most chemical associations (FDR<0.05) were observed with mean corpuscular volume (36 chemicals) and red blood cell counts (35 chemicals). For example, a doubling in the concentration of cotinine was associated with 0.16 fL (95% CI: 0.15, 0.17; FDR<0.001) increased mean corpuscular volume, and a doubling in the concentration of blood lead was associated with 61,736 increased red blood cells per μL (95% CI: 54,335, 69,138; FDR<0.001). A wide variety of chemicals, such as metals and smoking-related compounds, were highly associated with immune system biomarkers. This environmental chemical-wide association study identified chemicals from multiple families for further toxicological, immunologic, and epidemiological investigation.

MANAGEMENT OF MAMMARY FIBROADENOMA IN ROTTWEILER DOGS

Fibroadenoma mammae is a tumor that is formed from a mixture of fibrous and glandular tissue, usually known as a type of benign tumor that grows on mammae. The aim of this study is to report case management fibroadenoma in rottweiler dogs. A Rottweiler dog eight-year-old with a body weight of 24 kg, female sex with a lump in the left (sinistra) second mammary gland. A physical and clinical examination of the dog showed a healthy dog with a good appetite and drink, normal defecation and urination. Routine hematological examination showed an increase in MCV (Mean Corpuscular Volume) and a decrease in MCHC (Mean Corpuscular Hemoglobin Concentration), but not very significant. The results of histopathological examination of tumor tissue samples, the dog was diagnosed with fibroadenoma mammae with a fausta prognosis. Dogs are handled by performing surgery (excision) with the method of mastectomy (regional) to remove the tumor mass and give the antibiotics cefotaxim, cefixime with anti-inflammatory meloxicam, topical drugs such as Enbatic® and hematodin. After surgical removal of the tumor mass and administration of post-operative therapy, the case dog was declared cured with the surgical wound dry and fused on the fourteenth day. Handling fibroadenoma mammae it must be done as quickly as possible to prevent the tumor from metastasizing to other parts of the body.

Assessment of patho-physiological responses, gill histopathology and SEM analysis in common carp (Cyprinus carpio) exposed to varied doses of chloramine-T: A potent chemotherapeutic agent

Chloramine-T (Cl-T) is a chemo-therapeutant used at aquafarms to control fish mortalities associated with bacterial and parasitic infections in freshwater aquaculture. It is also effective as a disinfectant against a wide range of viruses known to cause disease in fish. However, a very little information is available on the patho-physiological alterations in common carp (Cyprinus carpio) exposed to different doses of Cl-T. Herein, the present study aimed to assess the patho-physiological changes in common carp exposed to different doses of Cl-T (20 mg/L, 100 mg/L, and 200 mg/L) for 15 days followed by a post-exposure assessment for another 15 days. The results indicated a significant decrease in haematological indices viz., Total Erythrocyte Count (TEC), Total Leucocyte Count (TLC), Total Platelet Count (TPC), Haemoglobin (Hb), Haematocrit (Hct), and Mean Corpuscular Haemoglobin Concentration (MCHC) at higher Cl-T concentrations. Whereas, a decrease in some of the immune-biochemical parameters was also noted viz., lysozyme, NBT, Total Ig, phagocytic activity, protein, albumin and globulin in a dose-dependent manner. However, a significant increase in Mean Corpuscular Volume (MCV) and glucose levels was observed during exposure period. Histopathological analysis revealed gill hypertrophy, fusion of secondary lamellae, sloughing of lamellar epithelium and gill necrosis which were more pronounced with increasing concentration of Cl-T. The maximum damage to the gill was noted at a concentration of 200 mg/L. Whereas, scanning electron microscopic (SEM) analysis of gill revealed sloughing of lamellar epithelium, reduced interlamellar space and hypertrophy of secondary lamellae in Cl-T exposed fishes. Together, these results suggest that Cl-T exposure in common carp at 20 mg/L has a mild and acceptable effect on gill and physiology of fish, 100 mg/L has moderate effect, and 200 mg/L causes extensive damage to gills and physiology of fish.

Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT) efficacy trial: Community health worker support may increase hydroxyurea adherence of youth with sickle cell disease.

Despite disease-modifying effects of hydroxyurea on sickle cell disease (SCD), poor adherence among affected youth commonly impedes treatment impact. Following our prior feasibility trial, the "Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT)" multi-site randomized controlled efficacy trial aimed to increase hydroxyurea adherence for youth with SCD ages 10-18years. Impaired adherence was identified primarily through flagging hydroxyurea-induced fetal hemoglobin (HbF) levels compared to prior highest treatment-related HbF. Eligible youth were enrolled as dyads with their primary caregivers for the 1-year trial. This novel semi-structured supportive, multidimensional dyad intervention led by community health workers (CHW), was augmented by daily tailored text message reminders, compared to standard care during a 6-month intervention phase, followed by a 6-month sustainability phase. Primary outcomes from the intervention phase were improved Month 6 HbF levels compared to enrollment and proportion of days covered (PDC) for hydroxyurea versus pre-trial year. The secondary outcome was sustainability of changes up to Month 12. The 2020-2021 peak coronavirus disease 2019 (COVID-19) pandemic disrupted enrollment and clinic-based procedures; CHW in-person visits shifted to virtual scheduled interactions. We enrolled 50 dyads, missing target enrollment. Compared to enrollment levels, both HbF level and PDC significantly - but not sustainably - improved within the intervention group (p=.03 and .01, respectively)with parallel increased mean corpuscular volume (MCV) (p=.05), but not within controls. No significant between-group differences were found at Months 6 or 12. These findings suggest that our community-based, multimodal support for youth-caregiver dyads had temporarily improved hydroxyurea usage. Durability of impact should be tested in a trial with longer duration of CHW-led and mobile health support.

In vitro Evaluation of DINCH-Plasticized Blood Bags for Red Blood Cell Storage with CPDA-1 Anticoagulant

Introduction: Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer commonly used in blood bags. Despite its protective effects on red blood cell (RBC) storage, concerns about its reproductive toxicity exist. This study investigated the in vitro quality of RBC concentrates stored in bags using di(isononyl) cyclohexane-1,2-dicarboxylate (DINCH) as an alternative plasticizer. Methods: Using a pool-and-split study design, we produced 20 matched homogenous quintets of RBC concentrates in two DINCH bags and three DEHP bags with citrate phosphate dextrose adenine (CPDA-1) anticoagulant. RBC storage quality was assessed weekly for 35 days. Results: On day 35, the median hemolysis levels in the DINCH bags (0.297–0.342%) were marginally higher (p < 0.05) than the DEHP bags (0.204–0.240%). All DINCH bags showed <0.8% hemolysis. RBCs in the DINCH bags showed increased mean corpuscular volume and decreased eosin 5′ maleimide binding than in the DEHP bags. Higher pO₂ and lower pCO₂ levels in the DINCH bags indicated better gas permeability than in DEHP bags. Other metabolic parameters were comparable in both bags. Compared to DEHP, DINCH exhibited considerably lower levels of plasticizer leaching into blood bags. Conclusion: The quality of RBC concentrates stored for 35 days in DINCH-plasticized blood bags with CDPA-1 is generally comparable to those in DEHP bags. Hence, DINCH can be a viable alternative to DEHP in blood bags for nonleukoreduced RBC storage even without the use of next-generation additive solutions to improve RBC preservation quality.

THE PROGNOSTIC VALUE OF BLOOD MARKERS IN PREDICTION OF THE PROBABILITY OF THE DEVELOPMENT OF FIBROTIC PROCESS IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS

Introduction. Recently, a negative trend of increasing the levels of prevalence, disability and mortality caused by chronic viral hepatitis C (HCV) infection has been determined. Around the world is defined 0.6-10.0 % suffer from chronic HCV (about 71 million with an annual increase of 1.75 million cases). Even higher are the levels of HCV seropositivity, which according to the WHO are about 100 million people (1.6 % of the world population). The WHO identified the need to improve the diagnosis of chronic HCV and to identify its asymptomatic forms and irreversible consequences (liver fibrosis and liver cirrhosis). Increasing the effectiveness of existing and developing new diagnostic approaches to improve early detection of chronic HCV and its consequences (liver fibrosis) is an urgent issue.&#x0D; The aim. To determine the prognostic possibilities of blood markers for the diagnosis of the development of the fibrotic process in chronic viral hepatitis C.&#x0D; Materials and methods. 78 people were examined: 47 (main group) – with chronic HCV and 31 – without chronic HCV (comparison group).&#x0D; Results. Probable associations with increased risks of development of LF in chronic HCV were: increased Mean Corpuscular Volume (MCV) (OR=4.305; 95.0 % CI 1.187-15.619; p=0.026) and Platelets (OR=0.955; 95.0 % CI 0.922-0.989; p=0.011), which indicated increased chances of developing LF in chronic HCV when exceeding the standard MCH indicators (by 4.305 times) and reduced chances – when increasing Platelets (on 4,5 %).&#x0D; Conclusions. Based on the research, it was determined that blood markers can be used as a significant predictor of the development of LF of patients with chronic HCV. Increased levels of MCH and Platelets in blood serum characterize a significant relationship with the development of LF in patients with chronic HCV, which indicates a significant influence of blood markers on the pathogenesis of LF in patients with chronic HCV.

Confounders of Serum Phosphatidylethanol: Role of Red Blood Cell Turnover and Cirrhosis.

Ethyl glucuronide (EtG), ethyl sulfate (EtS) and phosphatidylethanol (PEth) are considered specific direct biomarkers for detecting alcohol consumption. However, PEth, which is produced in red blood cells (RBC), varies considerably between patients for unknown reasons. We here studied various confounders of PEth elimination including fibrosis after alcohol withdrawal. EtG, EtS and PEth together with routine laboratory and clinical parameters were studied in 100 Caucasian heavy drinkers prior and after alcohol detoxification. In addition, fibrosis stage and degree of steatosis were assessed by transient elastography (Fibroscan, Echosens, Paris). All three biomarkers were highly correlated (0.61-0.72) with initial serum alcohol levels, but only PEth correlated with daily alcohol consumption. After alcohol withdrawal, PEth significantly decreased within 6.1 days from 1708 to 810 ng/mL (half-life varied from 1.6 to 15.2 days). Both levels of serum alcohol but also EtG and EtS were higher in patients with liver cirrhosis as compared to patients without fibrosis despite comparable alcohol consumption suggesting a decreased alcohol elimination in patients with cirrhosis. PEth was also elevated in cirrhosis but not significantly. In contrast, PEth elimination rate was significantly higher in patients with enhanced RBC turnover and signs of alcohol-mediated hemolytic anemia with elevated ferritin, LDH and increased mean corpuscular volume (MCV). We here demonstrate that alcohol elimination is decreased in patients with liver cirrhosis. In patients with cirrhosis, PEth levels are both affected in opposite directions by enhanced red blood cell turnover and elevated alcohol levels. Our data have important implications for the use and interpretation of PEth in the clinical setting.

CONFIRMATION OF DIAGNOSIS AND TREATMENT FOR A RHINITIS ALLERGY CASE IN A DOG

Rhinitis is a state of irritation and inflammation in the nasal area precisely in the nasal mucous membrane caused by allergic or non-allergic reactions. The case study aims to find out the appropriate diagnosis and therapy techniques for rhinitis cases. An examination was performed on a dog with complaints of sneezing and unilateral epistaxis for 10 days. Physical examination showed bilateral serous discharge mixed with blood from the nose and increased respiration frequency. X-rays of the thoracic region showed no significant abnormalities in the upper or lower respiratory tract. Cytological examination of nasal discharge revealed coccobacillus and simonsiela bacteria. Hematology examination results showed an increase in mean corpuscular volume (MCV) and a decrease in mean corpuscular hemoglobin concentration (MCHC). The therapy given to the case dog was causative, symptomatic, and supportive. Causative therapy was given in the form of antihistamine chlorpheniramine maleate® 4 mg in the amount of 4 mg/dog given orally twice a day for seven days. Symptomatic therapy was given antibiotics doxycycline hyclate® 100 mg in capsule form with the amount of 10 mg/kg BW given orally once a day for seven days and anti-inflammatory methylprednisolone® 4 mg in the amount of 0.3 mg/kg BW given orally twice a day for seven days. Supportive therapy was given caviplex 60 ml multivitamin with the amount of 1 mL once a day for seven days. As well as local hemostatic epinephrine is only given when the case dog has a blood-tinged discharge by inserting it into the nasal cavity using an iv catheter. The results of treatment for seven days showed an improvement in the condition characterized by no epistaxis, nasal discharge, and normal respiration in the case dog.

Effect of treatment of Helicobacter pylori with combination antibiotic therapy on iron deficiency anemia in patient with H. pylori-associated gastritis

Background: The failure to identify a cause of iron deficiency in a substantial subset of patients with low iron stores raises the question of whether there are additional as of yet unexplained causes of iron depletion. Recently, there has been a growing body of evidence to suggest a relationship between Helicobacter pylori gastritis and iron deficiency anemia (IDA) in the absence of peptic ulcer disease. Aims and Objectives: Therefore, the present study was undertaken to investigate the effect of treatment of H. pylori with combination antibiotic therapy on IDA in patient with H. pylori-associated gastritis. Materials and Methods: The present study was carried out at a tertiary care hospital catering to a large population in south Solapur and nearby areas. The study was conducted for 2 years. All patients with IDA attending outpatient department and admitted to the hospital for 2 years, were included in the present study. All patients who have IDA according to the World Health Organization criteria, as a hemoglobin concentration &lt;13 g/dL for men and &lt;12 g/dL for women, a mean corpuscular volume (MCV) &lt;75 fL and a serum ferritin level &lt; 30 ng/mL, both in-patient and outpatient setting were evaluated with detail history, clinical examination, and investigation. Results: Baseline hemoglobin (Hb) in group I is 8.99±1.23, while in group II 7.55±2.08.All the parameters are comparable in groups I and II except baseline Hb%. There is a significant increase in Hb, packed cell volume (PCV), MCV, mean corpuscular hemoglobin (MCH), and MCH concentration (MCHC) after 2 months of treatment with oral iron therapy. There is a significant increase in Hb, PCV, MCV, MCH, and MCHC after 2 months of treatment with oral iron and triple therapy for H. pylori. Conclusion: Treatment of H. pylori infection was associated with more rapid and significant response to oral iron therapy in IDA as compared with the use of iron therapy alone.

The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial

The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC). Eighty participants with UC were randomly assigned to take, either 1g/day (two 500mg capsules) spirulina (n=40) or placebo (n=40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial. Our results indicated significantly increased (p=0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p=0.004) whereas red blood cell count (p=0.01) and hematocrit (p=0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p=0.12) and the end of the trial (p=0.34). Eight weeks of 1g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo. These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3).

Evaluation and Comparison of the Effects of Low and High Doses of Herbal Medicinal Plant Emblic Myrobalan (AMLA) on Red Cell Parameters of Normal Healthy Rabbits

Objective: To study and compare the effects of low and high doses of Emblic myrobalan (Amla) on the red blood cells hemoglobin (Hb), packed cell volume (PCV) red cell count (RCC), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC) of rabbits. Study Design: Laboratory based experimental study. Place and Duration of Study: Department of Pharmacology, and Animal House of Baqai Medical University Karachi Pakistan, from Jul to Aug 2016. Methodology: Twenty-seven male rabbits of 1-2kg body weight were taken and equally divided into 3 groups (group A, B and C). Group A served as control group; group B (Low dose group) was administered Amla at 2g/kg body weight while group C (High dose group) was administered Amla at 4g/kg body weight. Amla was mixed with water and administered orally with syringe for 60 days. Blood samples were drawn via cardiac puncture on day 61 for red cell parameters and reports were analyzed using Statistically Package for Social Sciences (SPSS) version 21. Results: Administration of low dose Amla resulted in significant increase in Hb (0.001) and PCV (0.001) compared to normal while high dose Amla produced significant increase in Hb (0.001), PCV (0.001), MCV (0.043), MCH (0.027) and RCC (0.001). Administration of high dose Amla showed significant improvement in red cell parameters compared to low dose Amla. Conclusions: Amla may be used to improve the red cell hemoglobin in patients of iron deficiency anemia

Hydroxyurea treatment for adult sickle cell anemia patients in Kinshasa.

Background: Despite a high incidence of sickle cell anemia, hydroxyurea (HU) treatment is rarely used in the DR Congo. This study aims to assess the efficacy of HU, the incidence of side effects that may limit its use in adults and to determine the dose needed for clinical improvement in patients. Methods: In a prospective study, patients received an initial dose of 15mg/kg/day which was increased by 5mg/kg every 6 months, up to a maximum of 30mg/kg/day. The response and side effects to HU were evaluated biologically and clinically every 3 months during a 2-year period. Results: Seventy adult patients with a moderate or severe clinical phenotype initiated treatment. Only minor side effects were reported. At the end of the 2-year treatment phase, 45 (64.3%) had dropped out, of whom 33 were without a clear reason. Clinical and biological improvement was more marked during the first year. There was a reduction in severe vaso-occlusive crises (p<0.001), need for transfusion (p<0.001), and hospitalization days (p=0.038). Fetal hemoglobin (HbF) levels increased on average 2.9 times after 12 months (p<0.001). The increase in mean corpuscular volume was greater in the first year (p<0.001) than in the second year (p=0.041). The decrease in leukocytes (p<0.001) was significant during the first year. In 70% of patients, the 20mg/kg/day dose was needed to reach the 20% HbF threshold. Conclusion: HU is effective and well tolerated. The magnitude of the response varies from one patient to another. Improvement of clinical manifestations is achieved in most patients with a relatively low dose. Effective implementation of HU treatment will require improved adherence to treatment.

Hematobiochemical, serological, and molecular detection of Anaplasma marginale in dromedary camels (Camelus dromedarius) in Al-Najaf desert, Iraq.

Anaplasmosis, an underestimated disease transmitted by ticks, is widespread in ruminants, such as the Arabian camel (dromedary camel). This study aimed to examine the presence of Anaplasma marginale in dromedary camels in the Al-Hiadyia region of the Al-Najaf desert, Iraq, using serological and molecular tests. Moreover, hematological and biochemical changes in infected animals were compared with those in healthy controls. The study was conducted on 30 healthy and 260 infected camels with severe anemia, pale mucus membranes, and progressive emaciation to investigate antibodies against A. marginale using indirect enzyme-linked immunosorbent assay, followed by polymerase chain reaction for selected positive samples targeting a specific region of A. marginale major surface protein 5 (MSP5). In addition, hematological and biochemical parameters were measured to indicate the effect of the disease on blood profile, mineral status, and liver and kidney functions. Enzyme-linked immunosorbent assay analysis and microscopic examination revealed that 115/260 (44.23%) and 87 (33.46%) camels were positive for Anaplasma spp., respectively. The MSP5 gene, which is unique to A. marginale, was amplified. The results of hematological analysis indicated a significant decrease in total red blood cells, hemoglobin, and packed cell volume and a significant increase in mean corpuscular volume in infected camels, but no difference in mean corpuscular hemoglobin concentration. Moreover, there was a significant increase in total white blood cells count, lymphocytes, erythrocyte sedimentation rate, and platelets. The results of biochemical analysis indicated a significant increase in the levels of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, blood urea nitrogen, creatinine, and iron and a decrease in copper in infected camels. Cholesterol and triglyceride showed no significant variations between healthy and diseased camels. To the best of our knowledge, this is the first molecular study to demonstrate the presence of A. marginale in dromedary camels in Iraq. The MSP5 gene is a valuable and unique diagnostic target for identifying A. marginale.

Study of Socio-economic, Biochemical and Clinical Predictors of Alcohol Withdrawal and Delirium Tremens in Patients of Alcohol Dependence in Indian Population

Abstract Background: Alcohol withdrawal syndrome (AWS) is associated with morbidity and mortality. Assessment of factors affecting AWS will help in early diagnosis and initiation of appropriate treatment, hence improving the prognosis. Aim: The present study was conceived and planned to assess the socioeconomic, biochemical, and clinical predictors of alcohol withdrawal and delirium tremens with alcohol dependence patients in the Indian population. Study Design: Longitudinal study. Methodology: The study includes 100 patients admitted for alcohol withdrawal. Participants were assessed for detailed history, physical and mental state examination, CAGE scale (Cut down, Annoyed, Guilty, Eye-opener), AUDIT scale (Alcohol Use Disorders Identification Test), PAWSS scale (Prediction of Alcohol withdrawal severity Score), MINIPLUS (Mini-International Neuropsychiatric Interview) scale and CIWA scale (Clinical Institute withdrawal Assessment of Alcohol) scoring along-with biochemical and hematological investigations. Statistical analysis was done by using SPSS version 20. Results: Mean age of the patients observed was 33.91 years (19-70 years). A significant association between increase of mean corpuscular volume (MCV) and total bilirubin levels (P= 0.208); highly significant association between low platelet counts, low potassium levels, serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) and the development of delirium tremens and severity of alcohol withdrawal was observed (P&lt;0.05). CAGE (P&lt;0.014), AUDIT (P&lt;0.001), and CIWA scores has significant association (P&lt;0.001) with development of delirium and PAWSS showed good prediction (P&lt;0.007) with patients having severe alcohol withdrawal. Conclusion: Our study recommends that socioeconomic and biochemical factors and predictors can be considered for early diagnosis of severity of alcohol withdrawal and delirium tremens.