Mean Corpuscular Volume Levels Research Articles

Iron deficiency and early childhood caries: a systematic review and meta-analysis.

Backgrounds:Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC.Methods:The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software.Results:After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = −5.80, 95% CI: [−11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = −9.96, 95% CI: [−15.45, −4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = −3.72, 95% CI: [−6.65, −0.79], P = 0.01).Conclusions:ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.

Effect of vitamin B12 deficiency anemia on peripapillary retinal nerve fiber layer.

To evaluate the effect of vitamin B12 deficiency anemia (BDA) on peripapillary retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT), and to determine any correlation arising thereof. In this cross-sectional observational study, 99 eyes of 50 BDA patients of age 18-65y were compared with 100 eyes of 50 healthy control subjects. All subjects underwent comprehensive clinical, ophthalmic, and hematological evaluation, followed by peripapillary RNFLT assessment using SD-OCT. The mean total, inferior, nasal, and temporal RNFLT were significantly lower in BDA group as compared to control group (P<0.05). The mean total, inferior and nasal RNFLT correlated significantly (P<0.05) with serum Hb%, B12 and mean corpuscular volume (MCV) level (r=0.310, 0.435, -0.386 for total; r=0.932, 0.481, -0.513 for inferior; r=0.344, 0.254, -0.233 for nasal; respectively), while temporal and superior RNFLT quadrant did not show any correlation with any of the hematological parameters (r=0.144, 0.167, -0.096; r=0.111, 0.070, -0.099; respectively). The mean total RNFLT showed progressive thinning at par with the progression of anemia, except in very severe BDA, where an inverse relationship was documented. The mean total, inferior, nasal, and temporal peripapillary RNFLT was significantly thinner in BDA patients. Peripapillary RNFLT thinning seemed to proceed at par with the progression of severity of anemia, except in very sever grade. Early assessment of peripapillary RNFLT may be crucial in BDA patients to prevent potential blinding sequelae. Peripapillary RNFLT thinning in BDA patients should be considered in the differential diagnosis of other non-glaucomatous optic neuropathies, as well.

Iron Deficiency Anemia in Children and Adolescents with Type I Diabetes, Is it a Real Problem?

Abstract Background: Iron deficiency anemia (IDA) in children with type I diabetes (T1D) represents a significant burden. Aim of Study: To asses iron status in children and adoles-cent with T1D of and to correlate it with glycemic control and diabetic vascular complications. Patients and Methods: Two hundred children with T1D recruited from Pediatrics and Adolescent Diabetes Unit (PADU), Ain Shams University in the period from December 2019 to July 2020. They were 123 males (61.5%) and 77 females (38.5%) aged 10.97±3.93 years (Range: 2-18 years). History taking, fundus examination and general examination were done stressing on anthropometric measurements. Labo-ratory evaluation including complete blood count, glycosylated haemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), lipid profile and patients with microcytic hypochromic anaemia underwent Serum iron, total iron-binding capacity (TIBC), serum ferritin, Hepcidin, Anti-tissue transglutaminase (IgA), Occult blood in stool and H-pylori antigen in stool. Results: Seventy two of diabetic children were anemic (36%) and fifty one had IDA (25.5). IDA was more prevalent in males. Children with T1D and IDA experienced more clinically significant hypoglycemic attacks, more DKA attacks, high fatigue severity scale and history of menorrhagia. Low body weight, low BMI, low mean corpuscular volume (MCV), high TIBC and low hepcidin level were present in diabetic children with IDA. They also had high HbA1c, neuropathy, high triglycerides and high level of low density lipoprotein (LDL cholesterol). Conclusions: IDA is a significant morbidity among chil-dren with T1D and it should be screened. Serum hepcidin levels are significantly associated with iron status in children, and could be useful indicators of ID.

ASSOCIATION BETWEEN ANEMIA AND BONE PROFILE IN NON-DIALYSIS DEPENDENT CHRONIC KIDNEY DISEASE ANEMIA AND BONE PROFILE IN CKD

Objective: To determine association between iron deficiency anemia and bone profile in cases of chronic kidney disease not undergoing dialysis.&#x0D; Study Design: Comparative cross sectional study.&#x0D; Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology in collaboration with department of Nephrology, Armed Forces Institute of Urology, Rawalpindi, from Sep 2018 to Oct 2019.&#x0D; Methodology: A total of 300 chronic kidney disease patients who were not dependent on any kind of dialysis were included in our study. Chronic kidney disease was confirmed according to National Kidney Foundation/Kidney Disease Outcome Quality Initiative criteria. Hemoglobin, Mean corpuscular volume and ferritin levels were used to diagnose iron deficiency anemia. Association of Calcium, inorganic Phosphorous, Magnesium, Alkaline phosphatase and Parathyroid Hormone (PTH) was determined with iron deficiency anemia.&#x0D; Results: Out of 300 patients studied 201 (67%) were females while 99 (33%) were males. Mean age of participants was 43.51 ± 5.652 years. Mean duration of chronic kidney disease was 4.36 ± 3.712 years. One hundred and forty one (47%) patients had no anemia while 159 (53%) had presence of iron deficiency anemia. After applying binary logistic regression analysis hypocalcemia, hypophosphatemia and hypomagnesemia were noted to have a statistically significant association with iron deficiency anemia in the target sample size.&#x0D; Conclusion: This study revealed a high frequency of iron deficiency anemia in non-dialysis chronic kidney disease patients. Hypocalcemia, hypophosphatemia and hypomagnesemia were found having strong association with presence of iron deficiency anemia in non-dialysis dependent chronic kidney disease patients.

Associations between 3-phenoxybenzoic acid levels and hematological measures in adults: Korean National Environmental Health Survey 2012–2014

BACKGROUND AND AIM: Pyrethroid insecticides have been widely used for pest control in agriculture and residential spaces due to their high insecticidal effectiveness and low toxicity to humans. Several animal studies suggested that exposure to pyrethroids may induce bone marrow toxicity, resulting in inhibiting blood cell production. However, no studies have reported the effect of pyrethroid insecticide exposure on hematological changes in humans without occupational exposure. This study aimed to investigate the effect of 3-phenoxybenzoic acid (3-PBA) concentrations in urine on hematological parameters in Korea's representative adult population. METHODS: We analyzed data from 6,296 Korean adults recruited in the Korean National Environmental Health Survey (2nd round, 2012–2014). A multiple linear regression analysis was used to evaluate the association of urinary 3-PBA levels with eight hematological profiles of white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), platelet, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). RESULTS:Urinary 3-PBA levels showed a negative association with WBC, RBC, Hb levels and a positive association with MCV levels. The association varied by sex and age. The adverse effects of 3-PBA levels on hematological parameters were more pronounced among men aged 60 years and older. Among this age group, 3-PBA concentrations were negatively associated with WBC, RBC, Hb, Hct, and MCHC levels in men. However, among adults aged below 60 years, no associations were found between 3-PBA concentrations and any of hematological measure in either male or female. The associations remained significant on sensitivity analysis after controlling other urinary chemicals. CONCLUSIONS:This is the first study reporting evidence that 3-PBA concentration in urine, at levels found in a Korean population, may influence blood cell counts. This novel finding merits further investigation to understand the impact of 3-PBA on human blood function and population health. KEYWORDS: Pesticides, Environmental epidemiology, Biomarkers of exposure, Epidemiology, Big data

Analysis of relationship of hormonal, hematological and biochemical parameters in Indian alcoholics with severity of alcohol dependence

BackgroundAlcohol dependence syndrome (ADS) is a major problem in India. ADS is known to be a systemic disorder involving almost all organ-systems. The evaluation of ADS patients’ needs successive assessment of severity of clinical condition. In this study, we attempted to explore Severity of Alcohol Dependence Questionnaire (SADQ-C) as a severity measure by studying its association with laboratory parameters. MethodsDuring the two months study period 155 diagnosed ADS male patients who had been admitted to the Psychiatric Ward of two zonal level hospitals were enrolled for the study. The participants were examined by the Psychiatrist and the severity of alcoholism ascertained by the SADQ-C scoring. Based on SADQ-C scoring they were divided into three groups: severe alcohol dependence, moderate dependence and mild physical dependence. The patients’ blood samples were collected and tested. ResultsIn our study, morning and evening level of serum cortisol showed positive correlation with increasing SADQ-C scoring. The differences in morning and evening cortisol level also augmented with increasing severity score (r=0.257; p=0.001). Hemoglobin, mean corpuscular volume (MCV) and serum level of LH, FSH and testosterone levels were not shown any statistically significant alterations amongst the studied groups. Serum LH, total bilirubin, direct bilirubin, AST, ALT and GGT level showed positive correlation with SADQ-C scoring but AST/ALT ratio showed negative correlation. ConclusionThis study elaborated relationship between SADQ-C scoring and laboratory parameters in Indian male ADS patients. It highlighted the requirement of incorporation of serum cortisol along with presently evaluated laboratory parameters for ADS severity evaluation.

Comparison of the Toxic Effects of Pristine and Photocatalytically Used TiO2 Nanoparticles in Mice.

TiO2 nanoparticles used in the photocatalytic degradation of pollutants in water treatment processes undergo physiochemical changes; therefore, their toxicological effects may be potentially different from those of the pristine nanoparticles. This study compared the toxic effects of exposure to pristine and photocatalytically used TiO2 nanoparticles in mice. To obtain used TiO2, the nanoparticles were used for photocatalytic degradation of a model pollutant under UV irradiation several times. Two groups of mice were exposed to pristine (PT group) and photocatalytically used TiO2 (UT group) at three different concentrations (5-20mg/m3) using whole-body exposure chambers (2h/day, 5days/weeks, 4weeks). Exposure to both pristine and used TiO2 increased the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphate (ALP), lactate dehydrogenase (LDH), C-reactive protein (CRP), and creatine kinase (CK-MB) significantly. Both exposed groups showed higher levels of WBC, lymphocytes, platelets, hematocrits, hemoglobin, and mean corpuscular volume (MCV) and lower levels of RBC and mean corpuscular hemoglobin concentration (MCHC) in a concentration-dependent manner. In all analyses, there were small non-significant differences between the PT and UT groups. More pathological changes were observed in the lung, kidney, and brain of the UT group, while the PT group showed more pathological effects in the liver and heart. The histological observations indicated that damage was mostly in the form of vascular endothelial injury. These two types of TiO2 may activate different pathways to promote adverse effects. Further studies are required to evaluate and distinguish the mechanisms through which pristine and used TiO2 induce toxicity.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in burning mouth syndrome patients with thyroglobulin antibody/thyroid microsomal antibody positivity but without gastric parietal cell antibody positivity

Background/purposeOur previous study found that 222 of 884 burning mouth syndrome (BMS) patients have thyroglobulin antibody (TGA) positivity and/or thyroid microsomal antibody (TMA) positivity but without gastric parietal cell antibody positivity (GPCAˉTGA+/TMA+BMS patients). This study mainly assessed whether the serum TGA/TMA positivity was significantly associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCAˉTGA+/TMA+BMS patients. Materials and methodsThe complete blood count, iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between 222 GPCAˉTGA+/TMA+BMS patients and 553 GPCA-negative, TGA-negative, and TMA-negative BMS patients (GPCAˉTGAˉTMAˉBMS patients) or 442 healthy control subjects. ResultsWe found that 222 GPCAˉTGA+/TMA+BMS patients had significantly lower mean corpuscular volume (MCV) and lower blood Hb and serum iron levels than 442 healthy control subjects and significantly lower MCV and lower serum homocysteine levels than 553 GPCAˉTGAˉTMAˉBMS patients. Moreover, 222 GPCAˉTGA+/TMA+BMS patients had significantly greater frequencies of microcytosis, macrocytosis, blood Hb and serum iron deficiencies, and hyperhomocysteinemia than 442 healthy control subjects and significantly higher frequency of microcytosis but significantly lower frequency of hyperhomocysteinemia than 553 GPCAˉTGAˉTMAˉBMS patients. However, no significant differences in the frequencies of macrocytosis, blood Hb, serum iron, vitamin B12, and folic acid deficiencies were discovered between 222 GPCAˉTGA+/TMA+BMS patients and 553 GPCAˉTGAˉTMAˉBMS patients. ConclusionWe conclude that the disease of BMS itself does play a significant role in causing macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCAˉTGA+/TMA+BMS patients. However, the serum TGA/TMA-positivity is not significantly associated with anemia and serum iron, vitamin B12, and folic acid deficiencies in GPCAˉTGA+/TMA+BMS patients.

The effects of L-carnitine supplement on anemia in hemodialysis patients: A randomized clinical trial study

BACKGROUND: There is no general consensus about the effect of L-carnitine (LC) on anemic factors in hemodialysis patients. In this clinical trial, the effect of LC on anemia was investigated in these patients. METHODS: In a double-blinded clinical trial, hemodialysis patients admitted to the dialysis department of Tohid Hospital in Sanandaj, Iran, in 2017, were randomly divided into two groups of intervention (n = 40) and placebo (n = 40). Individuals in the intervention group received a dose of 1 g/day of LC, and the other group received placebo tablets of the same form for 12 weeks. Anemia factors were evaluated in both groups before and after the intervention. The data were analyzed using t-test and analysis of covariance (ANCOVA). RESULTS: The LC supplementation increased hemoglobin (Hb) in hemodialysis patients (P = 0.043). Moreover, the mean corpuscular volume (MCV) level was decreased under the effect of LC (P 0.050). CONCLUSION: The effect of LC supplement on Hb, serum ferritin, and MCV levels in hemodialysis patients was significant. Therefore, LC can be used to treat anemia in this group of patients.

Implications of Habitual Alcohol Intake With the Prognostic Significance of Mean Corpuscular Volume in Stage II-III Colorectal Cancer.

ObjectiveTo elucidate the prognostic significance of mean corpuscular volume (MCV), with implications of habitual alcohol intake in stage II-III colorectal cancer (CRC).BackgroundMCV had the potential to become an ideal prognostic biomarker and be put into clinical application. Few studies, however, have explored whether habitual alcohol intake which greatly increased the value of MCV would affect the prognostic role of MCV.MethodsEligible patients were identified from the CRC database of Fudan University Shanghai Cancer Center (FUSCC) between January 2012 and December 2013. Survival analyses were constructed using the Kaplan–Meier method to evaluate the survival time distribution, and the log-rank test was used to determine the survival differences. Univariate and multivariate Cox proportional hazard models were built to calculate the hazard ratios of different prognostic factors.ResultsA total of 694 patients diagnosed with stage II-III CRC between January 2012 and December 2013 were identified from FUSCC. Low pretreatment MCV was independently associated with 72.0% increased risk of overall mortality compared with normal MCV (HR = 1.720, 95%CI =1.028-2.876, P =0.039, using normal MCV as the reference). In patients with habitual alcohol intake, however, pretreatment MCV positively correlated with the mortality (P = 0.02) and tumor recurrence (P = 0.002) after adjusting for other known prognostic factors.ConclusionsIn CRC patients without habitual alcohol intake, low (<80 fL) level of pretreatment MCV was a predictor of poor prognosis. In patients with habitual alcohol intake, however, pretreatment MCV showed the opposite prognostic role, which would elicit many fundamental studies to elucidate the mechanisms behind.

THE EFFECTIVENESS OF A SCHOOL-BASED INTERVENTION FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA

Background: In Brazil, iron deficiency anemia is considered a public health problem, which has a direct impact on the process of child growth and development. To assess the impact of a powdered supplement added to food preparations, on hemoglobin (Hb) levels and other hematimetric parameters in children. Method: This study is a double-blind, community-controlled clinical trial conducted in education centers in the northeast of Brazil. In this trial, food preparations were offered with a powdered supplement, enriched with iron (intervention) and control (no supplementation), Monday through Friday, for 60 days. Two biochemical evaluations were performed to determine Hb, hematocrit (Ht), mean corpuscular volume and ferritin levels before and after the intervention. Results: For participants in the 6- to 59-month age range, we identified an increase in mean Hb concentrations and other hematimetric parameters. In the 5- to 11-year age group, there was a significant increase in both groups for Hb and Ht values, and mean Hb concentration was significantly greater in the intervention group (12.25±0.76 vs. 11.93±0.94, p&lt;.0035). In the 12- to 14-year-olds, all variables analyzed presented an increase. Conclusions: This school-based intervention effectively increased Hb concentrations other hematimetric parameters and reduced the prevalence of anemia in children and adolescents.

Iron Balance and Iron Nutritional Status in Preterm Infants During the First Four Months of Life.

To determine whether iron absorption occurs in a dose-dependent fashion and/or is a function of iron nutritional status (INS) in preterm infants during the first 4 months of life. Preterm very-low-birth-weight infants (VLBWI) were fed an iron-fortified (0.7 mg/dL) infant formula. Three 48 h balance studies were performed on each infant. INS was determined by serially measuring hemoglobin, mean corpuscular volume (MCV), hematocrit, ferritin, transferrin and transferrin saturation levels. The data were analyzed using ANOVA and stepwise regression. Fifty-four balance studies were performed in 18 infants (birth weight, 1347 ± 201 g; gestation, 30 ± 1.3 weeks; mean ± standard deviation) at 33 ± 1.3, 34 ± 1.2, and 48 ± 0.5 weeks corrected age and weights of 1768 ± 260, 2298 ± 314, 5127 ± 939 g. No relationship was detected between iron intake and absorption. Intake decreased during the study (1.17 ± .08, 1.24 ± 0.11 > 1.1 ± 0.15 mg · kg-1 · day-1) but net (0.32 ± 0.26, 0.36 ± 31 < 0.49 ± .23 mg · kg-1 · day-1) and % (27 ± 22, 29 ± 23 < 46 ± 21) absorption increased (P < 0.01). Serum ferritin, transferrin saturation and MCV fell, while hematocrit and hemoglobin remained stable. No relationship was noted between serum ferritin and iron absorption but transferrin saturation (54%), MCV (7%), and hematocrit (6%) accounted for 67% of the variation in iron absorption (P < 0.001). At intakes of 0.8-1.4 mg · kg-1 · day-1, iron absorption is not dose-dependent nor affected by iron stores. Only when iron delivery to the tissues decreases does absorption increase to meet needs in these otherwise normal and rapidly growing infants.

STUDY OF THE EFFECT OF OBESITY ON IMMUNE CELLS ACTIVITY AND CARDIOVASCULAR DISEASE RISK IN EL-OUED (ALGERIA) WOMEN

Objective: This study was conducted to find out the effect of obesity on immune cells activity and some biochemical markers in women.&#x0D; Methods: The experimentation is carried out on 30 voluntary individuals were divided into two groups; 15 women with obesity (Body Mass Index [BMI]&gt;30) were selected, On the other hand, we took 15 witnesses (BMI&lt;30). All the volunteers were subjected to estimate the lipid profile, biochemical, and hematological parameters.&#x0D; Results: Results obtained show that there was a significant increase of blood glucose (p&lt;0.05), triglyceride (p&lt;0.05) and uric acid (p&lt;0.001) and no significant change of other biochemical markers in obese people’s group when compared to the control subjects. In addition, the hematological results demonstrated that there was a significant decrease (p&lt;0.05) of lymphocytes, hemoglobin, hematocrit, and mean corpuscular volume levels (p&lt;0.01) in women with obesity compared to the controls.&#x0D; Conclusion: Our study reveals that the obesity may be induce the sever alteration in lipid profile which cause the cardiovascular risk for this population. In addition, the obesity causes a remarkable change in some biochemical markers and blood constituent’s anemia or other metabolic disorder in the body.

Комплаєнс до лікування левотироксином хворих на гіпотиреоз під час пандемічної ери SARS-CoV-2

Актуальність. Гіпотиреоз потребує замісної терапії левотироксином (L-T4), щоб підтримувати в пацієнтів стан еутиреозу. Кількість госпіталізацій з приводу хронічних захворювань зменшилась протягом ери COVID-19. Мета дослідження— встановити частоту госпіталізацій пацієнтів з гіпотиреозом під час пандемії COVID-19 порівняно з аналогічним періодом часу в 2019 році. Матеріали та методи. Дослідження було проведене серед пацієнтів, які звернулись у відділення внутрішньої медицини університетської лікарні Abant Izzet Baysal та отримували замісну терапію L-T4 внаслідок гіпотиреозу. 108 пацієнтів з гіпотиреозом були включені в дослідження, підписавши інформаційну згоду. Пацієнти були розділені на дві групи відповідно до прихильності до лікування: хворі, які відповідали вимогам лікування, і хворі, які не дотримувались режиму лікування. Результати. Рівень тиреотропного гормона (ТТГ) перед включенням у дослідження у групі осіб, які відповідали вимогам лікування, був вірогідно нижчим, ніж у групі хворих, які не дотримувались режиму лікування (p&lt;0,001). При цьому рівень вільного тироксину (вТ4) серед пацієнтів першої групи був вірогідно вищим, ніж в осіб другої групи (p=0,04). Медіана нерегулярного прийому левотироксину становила 35 (10–90) днів у групі осіб, які не відповідали вимогам лікування, і 0 (0–0) днів у групі осіб, які відповідали вимогам лікування (p&lt;0,001). Кількість днів, коли левотироксин використовувався нерегулярно, вірогідно позитивно корелювала з останнім значенням ТТГ (r=0,564, p&lt;0,001) та негативно— з останнім значенням вT4 (r=–0,492, p&lt;0,001). Середній об’єм еритроцитів (MCV) у хворих першої та другої груп становив 85 (69,1–97,5) та 89 (66–96,6) фл відповідно (p=0,03). Ретроспективний характер та порівняно невелика кількість досліджуваних були двома основними обмеженнями проведеного дослідження. Висновки. Дотримання режиму лікування є дуже важливим для досягнення стану еутиреозу в пацієнтів з гіпотиреозом під час пандемії COVID-19. Підвищений рівень MCV може передбачати невідповідність лікування у хворих на гіпотиреоз.

The prevalence of symptomatic knee osteoarthritis and its correlation analysis with complete blood count: a multicenter cross-sectional study in China

Purpose: The present study aims to estimate the prevalence of symptomatic knee osteoarthritis (OA) and analyze the correlation between symptomatic knee osteoarthritis and complete blood count (CBC) Results through large sample data from multiple centers in China. Methods: Nationally representative sample was derived from China Health and Retirement Longitudinal Study (CHARLS), a national random sample of the Chinese population, wave 3, which was mainly completed in 2015. A total of 21,100 individuals were interviewed, blood samples from 13,420 individuals were collected then. Individuals were asked whether they were often troubled with pain, after that, they’ll be asked to point out the site(s) of the body where he or she was currently experiencing pain, knee part included. At the same time, each individual was asked if he or she had a doctor-diagnosed arthritis. We define a subject as a symptomatic knee OA if he or she responded both questions positively. After data cleaning, a number of 12,952 individuals were categorized into four groups: (1) group 1: symptomatic knee OA individuals, (2) group 2: individuals who are suffering from knee pain but have no arthritis, (3) group 3: individuals who are diagnosed with arthritis but have no knee pain, (4) group 4: individuals without arthritis and knee pain. The flow chart of this study was shown in Figure 1. Post hoc multiple comparisons were conducted to analyze the CBC (hemoglobin, hematocrit, white blood cell count, platelet counts and mean corpuscular volume included) level in different groups. The criterion of significance is p < 0.05. Results: Among the 20,967 individuals included in the analysis, 19,692 answered both the knee pain and the doctor-diagnosed arthritis question, the prevalence of symptomatic knee OA was 9.18% (1,808 individuals). The CBC level (WBC, HGB, HCT, MCV, PLT) of the four groups was shown in Table 1 and Figure 2. Statistics showed that the hemoglobin level of symptomatic knee OA individuals (13.34±1.80 g/dL) was lower than that of other individuals (group 2 to 4: 13.51±1.98 g/dL, 13.62±2.03 g/dL, 13.82±1.92 g/dL, respectively), and the difference was statistically significant. The hematocrit level of symptomatic knee OA individuals (40.53±5.32 %) was lower than that of other individuals (group 2 to 4: 40.64±5.84 %, 41.23±5.83 %, 41.80±5.62 %, respectively), and the difference was statistically significant. The platelet counts level in arthritis individuals without knee pain was the lowest (199.09±76.88 ×109/L) when compared to other groups (group 1: 203.84±74.05 ×109/L, group 2: 208.21±81.03 ×109/L, group 4: 207.33±74.81 ×109/L). The level of white blood cell count and mean corpuscular volume showed no significance between the four groups. The significance between CBC level in the four groups was shown in Table 2. Conclusions: Symptomatic knee OA in China was still prevalent, the prevalence of symptomatic knee OA in 2015 was higher than that in 2011. Individuals with symptomatic knee OA had a tendency to lower hemoglobin and hematocrit, future research should pay more attention to effective treatment, management and prevention of symptomatic knee OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Dhatri Lauha in the management of iron deficiency anemia: A prospective open-label single-arm multi-center trial.

The burden of iron-deficiency anemia (IDA) remains persistently high in India due to the poor tolerability of oral iron supplementation. Therefore, more focus is required to explore traditional medicine for safe and effective options for managing IDA. To assess the clinical safety and efficacy of Dhatri Lauha in patients with IDA. An open-label, prospective, single-arm, multi-center trial was conducted at 12 centers with a sample size of 40 participants per study site. Patients with IDA aged 18-60 years with hemoglobin levels in the range of 6-10gm/dl, mean corpuscular volume (MCV) <80 fl, mean corpuscular hemoglobin concentration (MCHC) <34 μg/dl, serum ferritin <30 μg/dl and serum iron <50 μg/dl were included in the study. Dhatri Lauha 500 mg capsule was administered twice daily with lukewarm water after meals for 45 days. The primary outcome measure was the change in hemoglobin (Hb%) level from baseline to day 45. Secondary outcome measures included the change in MCV, MCHC, serum iron and ferritin levels, incidence of adverse events, and change in safety parameters (liver and kidney function tests). The mean (statistical) change in outcome measures from baseline to day 45 was compared using a paired sample t-test. Out of 458 participants enrolled in the study, 400 contributed to the final analysis. A significant difference was observed in the outcome parameters such as Hb%, MCV, MCHC, serum ferritin, and serum iron levels (P < 0.001) after 45 days of treatment. Mean Hb% changed from 8.46 ± 1.14 g/dl at baseline to 9.18 ± 1.61 g/dl on day 45 (P < 0.001). LFT and KFT were within the normal limits after the study period. No participant withdrew from the study due to adverse events. Dhatri Lauha is a safe intervention and can be expected to improve hemoglobin levels, red blood cell parameters, and iron stores in patients with IDA. Future RCTs with a larger sample size, standard care as control and a longer follow-up may produce more accurate and reliable results.

HEMATOLOGICAL MANIFESTATIONS OF CELIAC DISEASE AMONG CHILDREN: A SINGLE CENTER STUDY FROM SOUTH PUNJAB, PAKISTAN

OBJECTIVE:&nbsp;To find out various hematological manifestations among children from South Punjab, having confirmed celiac disease (CD). METHODS:&nbsp; This case-control study was done at The Institute of Child Health, Multan, Pakistan, from 1st February 2019 to 31st July 2019. We enrolled 139 children having CD, ranging in age from 1-12 years. An equal number of age and gender matched controls were also enrolled. Haematological parameters were compared between cases and controls. RESULTS: &nbsp;&nbsp; Majority (n=83/139; 59.7%) of children with CD were male. Mean age was 8.78±2.4 years. The common hematological manifestations among children with CD were anemia (n=127; 91.4%), thrombocytosis (n=104; 74.8%); leucopenia (n=10; 7.2%) and coagulopathy (n=13; 9.4%). Anemia alone was present in 20 (14.4%) children, anemia plus thrombocytosis in 91 (65.5%) cases, anemia plus leucopenia in 7 (5.0%) cases and anemia along with thrombocytosis and coagulopathy in 9 (6.5%) cases. Out of 127 cases of anemia, iron deficiency anemia (IDA) was noted in 96 (75.6%) cases, vitamin B12 and folate deficiency anemia in 14 (10.1%) cases whereas double deficiency anemia was seen in 17 (13.4%) cases. According to Modified Marsh Scoring, majority (n=46; 33.1%) of children had Type 3a CD. When compared to controls, CD cases had significantly lower haemoglobin, raised platelet count, lower mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) levels (p value&lt;0.0001). CONCLUSION: In children having CD, hematological manifestations are common. IDA is the most frequent hematological abnormality observed along with thrombocytosis in children with CD. Hematological parameters were significantly impaired among children with CD.

Management of iron deficiency anemia in hemodialysis patients based on mean corpuscular volume

BackgroundTo manage the anemic status in hemodialysis (HD) patients, a well-balanced combination therapy based on the use of erythropoiesis-stimulating agents (ESAs) and iron supplementation is essential. Serum ferritin level and transferrin saturation rate (TSAT) are the current standard tests for screening iron deficiency status. However, these are not included in frequently checked regular blood measurements in many HD centers. Other parameters that could predict a hemoglobin (Hb) increase response from iron supplementation have yet to be established. To determine a frequently checked and regularly measured biomarker for predicting iron deficiency status, this study investigated the value of mean corpuscular volume (MCV) as a clinical parameter for HD patients receiving intravenous iron supplementation (Fe-IV) therapy.Methods and resultsOne hundred thirty four HD patients, 88 non-HD patients with anemia, and 50 HD patients on Fe-IV therapy from the Nozatomon clinic were assessed. Comparison of MCV values of anemic HD patients and anemic non-chronic kidney disease (CKD) patients showed that anemic HD patients had significantly higher MCV values (93.9 ± 7.3 fL) compared with anemic non-CKD patients (82.8 ± 8.8fL). Fifty HD patients, who received Fe-IV therapy at ten consecutive HD sessions (inclusion criteria: Hb ≤ 12.0 g/dL, TSAT < 20%, and serum ferritin < 100 ng/mL) showed a rapid increase during the Fe-IV period in MCV, Hb, and TSAT levels. After the completion of the Fe-IV therapy, MCV persisted at the increased levels, whereas Hb levels further increased and peaked at 1 month with a gradual decline after, largely influenced by ESA dosage reductions. The 50 patients were divided into three groups according to the MCV levels obtained immediately prior to the Fe-IV therapy (MCV ≤ 85 fL, 85 fL < MCV ≤ 90 fL, MCV > 90 fL), and Hb changes at 50 days after the initiation of the Fe-IV therapy were compared. All the patients in the MCV ≤ 85 fL group and most of the patients in the 85 fL < MCV ≤ 90 fL group showed linear and consistent Hb increase during the 50-day period. In marked contrast, patients in the MCV > 90 fL group showed dispersed trends in their Hb increase. The present study also revealed that successful ESA dosage reduction could be achieved after the Fe-IV therapy in both the MCV ≤ 85 fL and 85 fL < MCV ≤ 90 fL groups.ConclusionsThe present study underscored the value of MCV in perceiving iron deficiency status as well as predicting iron-based therapeutic response in HD patients.

Development and validation of predictive models for Crohn's disease patients with prothrombotic state: a 6-year clinical analysis.

Crohn's disease (CD) is a chronic idiopathic inflammatory disease. Studies show that multiple risk factors during disease progression can lead to a prothrombotic state (PTS), which predisposes the patient to thrombosis. Therefore, predicting PTS can help identify patients at risk of thrombosis. The aim of our study was to classify CD patients through D-dimer levels, and construct a prediction model for PTS. The clinical and laboratory data parameters were extracted from a retrospective observational cohort. The factors significantly associated with PTS were determined by univariate analysis, and the importance rankings were calculated. Two multivariate models were then constructed using these factors to predict PTS in CD using logistic regression and random forest analysis. A total of 744 CD patients were included in the study, of which 116 were in PTS. The significant PTS-related factors were older patients, isolated colonic involvement, penetrating behavior, fever symptom, disease activity, abdominal surgery, lymphocyte counts, hematocrit levels, erythrocyte sedimentation rate, C-reactive protein, hematocrit, mean corpuscular volume levels and albumin. Multivariate logistic regression and random forest models predicted PTS with the accuracy of 89.73% and 90.63% respectively, and the corresponding AUC were 0.76 and 0.84. Two predictive models based on clinical and laboratory variables accurately identified CD patients with PTS with high precision.

Correlations of cardiac function with inflammation, oxidative stress and anemia in patients with uremia

The present study aimed to analyze the associations of cardiac function with inflammatory cytokines, oxidative stress and anemia in patients with uremia. A total of 79 patients with uremia were selected, and among those, 43 cases were complicated with cardiac dysfunction (observation group) and 36 patients were not (control group). The levels of inflammatory cytokines [C-reactive protein (CRP), interleukin-6 (IL-6) and IL-10], oxidative stress indicators [malondialdehyde (MDA), oxidized low-density lipoprotein (OX-LDL) and advanced oxidation protein products (AOPP)], blood routine parameters [hemoglobin (Hb), platelets (PLT), mean corpuscular volume (MCV)], and cardiac function [including cardiac output (CO), cardiac stroke volume (SV), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd) and left ventricular end-systolic diameter (LVESd)] were measured. There were no statistically significant differences in age, sex, body mass index, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol between the observation and the control group (P>0.05), but the observation group had significantly higher triglyceride levels and blood pressure, as well as longer duration of uremia compared with those in the control group (P<0.05). Furthermore, the levels of CRP, IL-6, IL-10, MDA, OX-LDL, AOPP, Hb, PLT and MCV in the observation group were significantly higher than those in the control group. In addition, regarding cardiac function, the observation group had a decreased CO, SV and LVEF and an increased LVEDd and LVESd compared with those in the control group. Furthermore, CRP (r=-0.636, P<0.01) and MDA (r=-0.705, P<0.01) were negatively correlated with LVEF, while Hb levels were positively correlated with LVEF (r=0.732, P<0.001). In conclusion, serum inflammatory cytokines, oxidative stress and the degree of anemia are associated with cardiac insufficiency in patients with uremia.