Mean Corpuscular Volume Levels Research Articles

Risk of low levels of blood group antibodies mediating hemolysis in ABO-incompatible neonates with negative three hemolysis tests

ObjectiveTo explore the risk of low-level blood group antibody-mediated hemolysis in ABO-incompatible newborns with negative three hemolysis tests, aiming to assist in the identification and management of neonatal jaundice.MethodsA retrospective case-control study was performed in 892 children with jaundice. The patients were divided into three groups: group I, ABO compatible, negative three hemolysis tests; group II, ABO incompatible, negative three hemolysis tests; and group III, ABO incompatible, positive three hemolysis tests. We analyzed the differences in clinical data, blood routine and biochemical laboratory results.Results(1) Patients in group II had higher levels of mean corpuscular volume (MCV), standard deviation of red blood cell volume distribution width (RDW-SD), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and bile acid (BA) than those in group I (P < 0.05). However, there were no statistically significant differences in the MCV, ALT, ALP and BA levels between groups II and III (P > 0.05). (2) Mean corpuscular hemoglobin concentration (MCHC) >359.5 g/L, cell volume distribution width (RDW-CV) >15.95%, and reticulocyte count (RET) >4.235% were identified as independent predictors of positive hemolysis test results (P < 0.001). The combination of MCHC, RDW-CV, and RET% yielded an AUC of 0.841.ConclusionLow-level blood group antibody-mediated hemolysis may occur in ABO-incompatible neonates even when three hemolysis tests are negative. Changes in liver function parameters must be monitored. The combination of MCHC, RDW-CV, and RET% can be used to improve the detection rate of HDN.

Evaluation of Erythrocytes Indices, Platelet Indices and Complete Blood Count in Feline Mammary Carcinomas

The aim of this study was to evaluate the differences in the platelet (PLT) indices and complete blood count (CBC) parameters between the cats with mammary tumor and healthy individuals. Also, the differences in above mentioned parameters are going to be investigated in cats with mammary tumors with regard to clinicopathological characteristics of the primary tumor. A total of 44 female cats were included in the study. The study groups consisted of cats with mammary tumors (Group MT, n=22) and healthy cats presented for neutering (Group H, n=22). The ages of the cats were ranged between 5-15 years. All data on CBC, thoracic radiography, clinical examination findings and histopathology were obtained from the the patient archive in the animal hospital automation system. While the highest red blood cell (RBC) and hemoglobulin (HGB) levels were observed in Group H, Group MT had the highest white blood cell (WBC), mean platelet volume (MPV) and plateletcrit (PCT) levels. The mean corpuscular volume (MCV) level in T1 was significantly lower than in T2-T3. The MCV level in G1-G2 tended to be higher compared to G3. In Group MT, CBC parameters were not significantly different related to the presence of metastasis, presence of ulceration and inflammation on the tumor. It was concluded that evaluation of CBC and PLT indices in cats with mammary tumors would be useful in understanding the hematological effects of the disease and tumor characteristics (tumor size and histological grade).

Clinical and genetic characteristics of Chinese pediatric and adult patients with hereditary spherocytosis

ObjectiveThis study aimed to investigate the clinical features, pathogenic gene variants, and potential genotype–phenotype correlations in Chinese patients with hereditary spherocytosis (HS).MethodsRetrospective analysis of clinical data and molecular genetic characteristics was conducted on patients diagnosed with HS at Jiangxi Provincial Children's Hospital, the Second Affiliated Hospital of Nanchang University, Pingxiang People's Hospital and The Third People's Hospital of Jingdezhen between November 2017 and June 2023. Statistical analyses were performed to compare and analyze the red blood cell (RBC), hemoglobin (HB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) data between and within groups based on different mutations and age groups (< 14 and ≥ 14 years).ResultsA total of 34 HS patients were included in this study, comprising 22 children (64.70%) and 12 adults (35.30%). The probands who underwent genetic testing were derived from 34 unrelated families. Thirty-two variants were tested and 9 of them are novel. Eighteen cases had ANK1 variants, 15 had SPTB variants, and 1 had SLC4A1 variant. 25 patients performed core family members underwent genetic testing, 17 (68.0%, 17/25) were de novo, 5 (20.0%, 5/25) were maternally inherited, and 3 (12.0%, 3/25) were paternally inherited. ANK1-HS patients exhibited more severe anemia compared to cases with SPTB-HS, showing lower levels of RBC and HB (P < 0.05). Anemia was more severe in patients diagnosed in childhood than in those diagnosed in adulthood. Within the ANK1-HS group, MCH levels in adult patients was significantly higher than those in children (P < 0.05), while there were no significant differences in RBC, HB, MCV, and MCHC levels between two groups. Adult patients with SPTB-HS had significantly higher levels of RBC, HB, and MCH than pediatric patients (P < 0.05), while MCV and MCHC levels showed no significant statistical differences.ConclusionThis study conducted a comparative analysis of phenotypic characteristics and molecular genetics in adult and pediatric patients diagnosed with HS, confirming that pediatric ANK1-HS patients exhibit a more severe anemic phenotype compared to SPTB-HS patients, while the severity of HS in adults does not significantly differ between different causative genes.

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.

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.

Molecular characterization of similar Hb Lepore Boston-Washington in four Chinese families using third generation sequencing.

Hemoglobin (Hb) Lepore is a rare deletional δβ-thalassemia caused by the fusion between delta-beta genes, and cannot be identified by traditional thaltassemia gene testing technology. The aim of this study was to conduct molecular diagnosis and clinical analysis of Hb Lepore in four unrelated Chinese families using third generation sequencing. Decreased levels of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and an abnormal Hb band were observed in the probands of the four families. However, no common α and β-thalassemia variants were detected in the enrolled families using polymerase chain reaction-reverse dot blot hybridization based traditional thalassemia gene testing. Further third-generation sequencing revealed similar Hb Lepore-Boston-Washington variants in all the patients, which were resulted from partial coverage of the HBB and HBD globin genes, leading to the formation of a delta-beta fusion gene. Specific gap-PCR and Sanger sequencing confirmed that all the patients carried a similar Hb Lepore-Boston-Washington heterozygote. In addition, decreased levels of MCH and Hb A2 were observed in the proband's wife of family 2, an extremely rare variant of Hb Nanchang (GGT > AGT) (HBA2:c.46G > A) was identified by third-generation sequencing and further confirmed by Sanger sequencing. This present study was the first to report the similar Hb Lepore-Boston-Washington in Chinese population. By combining the utilization of Hb capillary electrophoresis and third-generation sequencing, the screening and diagnosis of Hb Lepore can be effectively enhanced.

Evaluation of Hematological and Biochemical Effects of Kabuuti Herbal Cough Syrup: A Sub-acute Study in Wistar Rats

Herbal medicines, including Kabuuti cough syrup, have gained popularity in treating various ailments, yet their safety and efficacy require scientific scrutiny. This study aimed to evaluate the hematological and biochemical effects of Kabuuti herbal cough syrup after 28 days of oral administration in Wistar rats. The herbal extracts, containing secondary metabolites like terpenes, alkaloids, steroids, and phenols, were administered at different doses to rats, with distilled water as a control. Hematological and biochemical parameters were assessed, showing no statistically significant changes in most parameters. However, there were decreases in mean corpuscular volume (MCV) levels and lymphocyte percentage and increases in hemoglobin (HB) levels and gamma glutamyl transferase (GGT) levels observed in certain dosage groups. Despite these variations, the overall findings suggest that Kabuuti herbal cough syrup is safe for liver and kidney function in the short term, with no significant adverse effects observed. Keywords: Kabuuti Cough Herbal Preparation; Haematological Effects; Biochemical Effects; Oral Administration; Wistar Rats.

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.

Blood Indices of the Patients with β-Thalassemia Minor Compared to the Patients with β-Thalassemia Minor-Alpha-Thalassemia

Objective: Thalassemia, as one of the most common genetic diseases, is a group of hereditary hemoglobin disorders due to a slight disturbance in the production of alpha and beta globin chains in the structure of hemoglobin occurs. There are still no clear criteria for differentiating thalassemia types based on hematological findings. In the current study, we aimed to evaluate the low-grade beta-thalassemia (β-thalassemia) indices in comparison with β-thalassemia minor with alpha-thalassemia (α-thalassemia).&#x0D; Methods and materials: In this descriptive-analytic study, 120 patients were enrolled, including 80 patients with minor β-thalassemia and 40 patients with minor β-thalassemia with α-thalassemia. Of all patients, 5cc blood samples were taken. The red blood cell parameters including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and hemoglobin were determined. The level of MCV&gt; 80 and A2&gt; 3.5 β-thalassemia minor and MCV &lt;80 and A2 &lt;3.5 were considered as elevated thalassemia or iron deficiency anemia.&#x0D; Results: The results showed that the mean of hemoglobin, HCT, MCH, MCHC, and MCV in the β-thalassemia group was significantly lower than that of the β-thalassemia with α-thalassemia group (P &lt;0.0001). On the other hand, the level of these indices in the control group was significantly higher than in the two groups of patients (P&lt;0.0001). The results showed that the percentage of hemoglobin A2 in the β-alpha-thalassemia group was 4.5 ± 0.91, significantly higher than the β-thalassemia group. The rate of hemoglobin and MCV was significantly lower in the β-thalassemia group compared to the silent and trait β+αthalassemia group. Also, the rate of hematocrit was significantly lower in the β-thalassemia group compared to the trait, although had no significant difference with the silence group.&#x0D; Conclusion: Based on our findings, despite the difference between some hematocrit indices in the patients with β-thalassemia and β-αthalassemia, these indices cannot be used as differential indices.

Retrospective Study Comparing Treatment Outcomes in Obstetric Patients With Iron Deficiency Anemia Treated With and Without Intravenous Ferric Carboxymaltose.

Introduction Iron deficiency anemia is associated with an increased risk of adverse maternal and perinatal outcomes. Intravenous iron preparation containing ferric carboxymaltose has been shown to be a safe and effective way of increasing hemoglobin (Hb) and mean corpuscular volume (MCV) levels and reducing the need for blood transfusion. In our center, it used to be given as an inpatient procedure because of the risks of potential drug reactions. In 2021, we initiated the administration of intravenous ferric carboxymaltose as an outpatient procedure. We compared the outcomes of patients between 2021 and 2023 after the initiation of outpatient administration of intravenous ferric carboxymaltose in 127 obstetric patients with iron deficiency anemia in the second and third trimesters. Methods In this study conducted in a large maternity unit in Singapore between 2021 to 2023, we compared the changes in maternal hematological parameters among obstetric patients with iron deficiency anemia presenting to the day care unit in the second or third trimester with a Hb level of <8 g/dl treated with a single dose of ferric carboxymaltose injection (Ferinject) against a control group who were referred for treatment but defaulted on and declined treatment. Results Ferric carboxymaltose significantly increased the Hb and MCV levels at delivery in obstetric patients with iron deficiency. The mean Hb at delivery was 10.8 g/dL in the case group compared to 8.8 g/dL in the control group. The percentage of patients with Hb ≥10.0 g/dL was 73.4% in the case group compared to 27.8% in the control group. The incidence of adverse side effects was low and mild (2/127; 1.6%). None of the patients received were hospitalized because of ferric carboxymaltose. Conclusion A single injection dose of ferric carboxymaltose as an outpatient antenatal procedure was easily administered and well tolerated. Obstetric patients with iron deficiency anemia who received intravenous ferric carboxymaltose had a significantly higher level of Hb than those who did not.

HEMATOLOGICAL DYNAMICS IN HEMODIALYSIS: A COMPREHENSIVE EXAMINATION OF PATIENTS WITH CHRONIC RENAL FAILURE IN A TERTIARY CARE HOSPITAL

Background: Chronic kidney disease (CKD) is a significant health burden in developing countries like India, leading to high morbidity and mortality rates. The study aimed to determine the incidence of anemia among patients with CKD and examine its potential association with other predictive markers. Methods: A cross-sectional observational research was undertaken within a tertiary hospital setting to examine the incidence of hematological abnormalities and explore the association between anemia and its many manifestations in patients with stages 3-5 chronic kidney disease (CKD). The markers for anemia encompassed measurements of hemoglobin percentage (Hb%), mean corpuscular volume (MCV), and examination of peripheral smears. The investigation also examined the correlation between stages of chronic kidney disease (CKD) and red cell distribution width (RDW), thrombocytopenia, leucocyte count, and differential count. Result: The study found that 96.8% of participants displayed symptoms of anemia, characterized by normocytic and normochromic observations on peripheral measures. A significant number of patients (57.3% of them) had a higher total leucocyte count (TLC), but there was no statistically significant link between a higher TLC and the worsening stages of CKD. The mean corpuscular volume (MCV) and platelet levels exhibited a predominantly normal range, with relatively few observed fluctuations. However, there is a positive link between the advancement of CKD and an increase in red cell distribution width (RDW). Conclusion: The study highlights the changes in blood parameters observed in individuals with CKD, with particular attention given to the high occurrence of anemia. The findings underscore the importance of comprehensive iron investigations and the timely identification and intervention of anemia. Adopting a comprehensive strategy that includes regular monitoring of blood parameters, specifically focusing on anemia and iron levels, is crucial for effectively managing and enhancing the overall health of individuals with CKD KEY WORDS- Anemia in CKD, Chronic kidney disease, Iron deficiency anemia

Anaemia among school children of different socioeconomical status in a city of Southern Brazil

Background: Iron deficiency is one of the leading causes of anaemia, with those most affected being children and women of childbearing age, in Brazil there is a scarcity of studies involving the local prevalence of anaemia. Aim: To evaluate anaemia and associated factors in schoolchildren in Santa Cruz do Sul through the analysis of biochemical and haematological markers and parasitological examination of faeces. Subjects and methods: School children from 10 to 12 years of age were evaluated through complete blood count, serum ferritin, C-reactive protein and stool parasitological examination, as well as socio-demographic characteristics and prophylaxis with ferrous sulphate in childhood. Results: It was found that 13.0% of the population was anaemic, girls were very slightly overrepresented among the anaemic children. Only 5.3% had altered haematocrit levels; 26.6% had low Mean Corpuscular Volume levels; 18.4% had low ferritin levels; 2.4% had increased C-reactive protein levels, and 21.7% had altered eosinophils. As for the socioeconomic level, classes A2 and D presented lower haemoglobin levels, as well as class D presenting lower ferritin levels, although without statistical significance. Only 6.0% of the population presented iron-deficiency anaemia and 46.0% of the schoolchildren had used ferrous sulphate supplementation in childhood. Conclusion: The prevalence of anaemia in the studied municipality is low, probably due to the high municipal human development index. Epidemiological studies are essential to characterise the population in a systematic form, to prevent future problems.

Third-generation sequencing identified two rare α-chain variants leading to hemoglobin variants in Chinese population.

Rare and novel variants of HBA1/2 and HBB genes resulting in thalassemia and hemoglobin (Hb) variants have been increasingly identified. Our goal was to identify two rare Hb variants in Chinese population using third-generation sequencing (TGS) technology. Enrolled in this study were two Chinese families from Fujian Province. Hematological screening was conducted using routine blood analysis and Hb capillary electrophoresis analysis. Routine thalassemia gene testing was carried out to detect the common mutations of α- and β-thalassemia in Chinese population. Rare or novel α- and β-globin gene variants were further investigated by TGS. The proband of family 1 was a female aged 32, with decreased levels of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), Hb A2, and abnormal Hb bands in zone 5 and zone 12. No common thalassemia mutations were detected by routine thalassemia analysis, while a rare α-globin gene variant Hb Jilin [α139(HC1)Lys>Gln (AAA>CAA); HBA2:c.418A>C] was identified by TGS. Subsequent pedigree analysis showed that the proband's son also harbored the Hb Jilin variant with slightly low levels of MCH, Hb A2, and abnormal Hb bands. The proband of family 2 was a male at 41 years of age, exhibiting normal MCV and MCH, but a low level of Hb A2 and an abnormal Hb band in zone 12 without any common α- and β-thalassemia mutations. The subsequent TGS detection demonstrated a rare Hb Beijing [α16(A14)Lys>Asn (AAG>AAT); HBA2:c.51G>T] variant in HBA2 gene. In this study, for the first time, we present two rare Hb variants of Hb Jilin and Hb Beijing in Fujian Province, Southeast China, using TGS technology.

Anaemia-based screening for resistance to thyroid hormone alpha in children.

The hypothyroid phenotype associated with resistance to thyroid hormone alpha (RTH-α) is associated with a diverse clinical picture. On the other hand, thyroid-stimulating hormone (TSH) levels are normal. Free triiodothyronine (fT3) and free thyroxine (fT4) levels can also be normal; however, normo- or macrocytic anaemia is usually present in reported cases. Diagnosis is challenging and there is limited data regarding screening methods. The study aimed to assess the efficiency of a screening strategy for RTH-α. Out of a total of 6540 children evaluated at the outpatient clinics of paediatric neurology over 2 years and who underwent complete blood count and thyroid function tests, 432 were found to have anaemia. Within this group, we identified 42 children without an underlying specific neurological aetiology who exhibited normo- or macrocytic anaemia, normal TSH levels, fT3 levels in the upper half of the normal range or high, and fT4 levels in the lower half of the normal range or low. We excluded one patient who had already been diagnosed with RTH-α and nine patients could not be reached. Subsequently, clinical evaluation, biochemical assessment, and THRA sequencing analysis were conducted on 32 children. The findings were compared with those of the known RTH-α patients in our unit. The median age of the patients was 5.7 (5.1-7.4) years, and 22 of them were males (69%). The main reasons for assessment in paediatric neurology clinics were autism spectrum disorder (n = 12, 38%), epilepsy (n = 11, 34%), and delay in developmental stages (n = 8, 25%). Constipation was present in five of the cases (16%), while the closure of the anterior fontanelle and tooth eruption were delayed in two cases (6%) and one case (3%), respectively. The median length/height and weight standard deviation (SD) scores were 0.3 [(-0.8)-(1.1)] and -0.1 [(-0.8)-(0.3)], respectively. The median fT3, fT4, and TSH levels were 4.6 (4.2-5.0) pg/mL, 0.9 (0.8-1.0) ng/dL, and 2.2 (1.8-3.1) uIU/mL, respectively. Thirteen of the patients (41%) had high fT3 levels, while none of them had low fT4 levels. The normo- or macrocytic anaemia rate was 47% (normocytic/macrocytic, n = 8/7) at the time of reassessment. Serum creatine kinase (CK) was elevated in five patients (16%; one had anaemia). None of the subjects had a pathological variant in THRA. Known RTH-α patients had significantly lower median height SD score, higher rates of delayed tooth eruption and closure of the anterior fontanelle, lower haemoglobin levels, and higher mean corpuscular volume (MCV) and CK levels as compared to those found without RTH-α. This approach found one known patient with RTH-α but did not reveal any new cases. Notably, normo- or macrocytic anaemia did not persist in nearly half of the screened patients. A screening strategy that takes clinical findings and prominent laboratory features suggestive of RTH-α into account could lower unnecessary genetic analysis of THRA in patients presenting with neurological problems.

Evaluation of Prevalence and Severity of Anemia among Non-pregnant women of Reproductive Age in Garmian Province, Iraqi Kurdistan Region

Anemia is a major significant public health issue that affects both pregnant and non-pregnant women throughout the world. This study aimed to determine the prevalence and severity of anemia, as well as its classification, based on MCV values in non-pregnant women residing in the Garmian province in the east of Iraq. Blood samples were collected from non-pregnant women between the ages of 16 and 49 years. Anemia is classified as mild, moderate and severe, and as microcytic, normocytic and macrocytic depending on the level of Hb or mean corpuscular volume (MCV) respectively. In this study sociodemographic and hematological characteristics were also evaluated. The results showed that 56% of the study samples were anemic, and of the total anemic patients, 54 (35%), 86 (55%) and 16 (10%) had mild, moderate, and severe anemia respectively. Also, of the total anemic patients, 102 (65%) had microcytic type of anemia, 51 (33%) had normocytic anemia and only 3 (2%) had macrocytic anemia. The majority of anemic women (77.6%) had normal RBC counts but low Hct, MCH and MCHC values of 76.3%, 79.5% and 81.4%, respectively. The results showed also that there was no significant difference between the severity of anemia and age groups, occupation, blood pressure, bleeding, and haemorrhoids. However, diabetics showed a significant difference in anemia severity with &lt;0.0004 P-value. The results showed that anemia had become a major public health issue in the study area.

Prevalence and genetic analysis of triplicated α-globin gene in Ganzhou region using high-throughput sequencing.

α-globin gene triplication carriers were not anemic in general, while some studies found that α-globin gene triplication coinherited with heterozygous β-thalassemia may cause adverse clinical symptoms, which yet lacks sufficient evidence in large populations. In this study, we investigated the prevalence and distribution of α-globin gene triplication as well as the phenotypic characteristics of α-globin gene triplication coinherited with heterozygous β-thalassemia in Ganzhou city, southern China. During 2021-2022, a total of 73,967 random individuals who received routine health examinations before marriage were genotyped for globin gene mutations by high-throughput sequencing. Among them, 1,443 were α-globin gene triplication carriers, with a carrier rate of 1.95%. The most prevalent mutation was αααanti3.7/αα (43.10%), followed by αααanti4.2/αα (38.12%). 42 individuals had coinherited α-globin gene triplication and heterozygous β-thalassemia. However, they did not differ from the individuals with heterozygous β-thalassemia and normal α-globin (αα/αα) in terms of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) levels. In addition, heterogenous clinical phenotypes were found in two individuals with the same genotype. Our study established a database of Ganzhou α-globin gene triplication and provided practical advice for the clinical diagnosis of α-globin gene triplication.

CORRELATION AND PREVALENCE OF MEGALOBLASTIC ANAEMIA IN TYPE 2 DIABETIC PATIENTS USING METFORMIN

Background: Metformin is the most widely used drug in the management of type 2 diabetic patients but its use is associated with vitamin B12 deficiency induced megaloblastic anaemia. However few studies in Pakistan have assessed this risk. This study was conducted to determine correlation and prevalence of megaloblastic anaemia in type 2 diabetics treated with metformin. Methods: This cross-sectional study was carried out in the Department of Medicine, Hayatabad Medical Complex, Peshawar from Dec 2021 to Nov 2022. A total of 156 type 2 diabetic patients who were taking metformin at least for the last 2 years, were included in the study. All these patients were evaluated for anaemia, raised Mean Corpuscular Volume (MCV) and vitamin B12 levels. Results: Out of 156 patients who participated in the study, 94 (60.25%) were male and 62 (39.75%) were female with a mean age of 57.56±8.5 years. Mean duration of diabetes was 7.37±3.61 years, whereas mean duration of metformin use was 5.85±2.9 years. Vitamin B12 deficiency was identified in 51 (32.69%) patients. These B12 deficient patients demonstrated a mean Hb of 9.8±1.4 g/dL. Hyper-segmented neutrophils and raised MCV (mean MCV 98.7±6.90 fl was also identified in them. There was a no correlation between serum B12 levels and dose and duration of metformin. Conclusion: Long term metformin use is significantly associated with B12 deficiency associated megaloblastic anaemia. Diabetes Mellitus, Metformin, HbA1C, Vitamin B12, Megaloblastic Anaemia Pak J Physiol 2023;19(3):23–6

Cold agglutinin syndrome in a patient with human immunodeficiency virus infection

Abstract A 44-year-old female with no prior comorbidities presented with a history of easy fatiguability and yellowish discolouration of eyes of 3 months duration. On examination, she had pallor and icterus. Jugular venous pressure was elevated. Earlier, the patient was diagnosed to have autoimmune haemolytic anaemia and was started on steroids 2 weeks ago elsewhere. Laboratory investigations showed severe anaemia, elevated mean corpuscular volume and lactate dehydrogenase levels. Corrected reticulocyte count was 2.5%. Unconjugated hyperbilirubinaemia was evident. Coomb’s test was positive. In view of suspicion for cold agglutinin syndrome (CAS), monospecific agglutinin test with cold agglutinin titres was done, which tested positive. Serological testing was positive for human immunodeficiency virus (HIV) 1. The patient was diagnosed to have CAS secondary to HIV infection.

Effect of different stocking densities on hematological parameters and zootechnical performance of pacu (Piaractus mesopotamicus) in the BFT system

This study evaluated the growth performance and hematological parameters of pacu (Piaractus mesopotamicus) juveniles (37.10 ± 0.35 g) subjected to different stocking densities (SD) in the biofloc technology (BFT) system. The individuals were distributed in five different SD: 200, 400, 600, 800, and 1000 fish m−3 (here called SD200, SD400, SD600, SD800, and SD1000, respectively) for 45 days. The experimental design was randomized entirely into five treatments and three replicates. The physical-chemical parameters of water quality remained stable. Survival was >94% in all treatments. Increasing SD had a positive linear effect on initial (R2 = 1.00) and final biomass (R2 = 0.87) and a negative linear effect on final weight (R2 = 0.93), final length (R2 = 0.92), weight gain (R2 = 0.93), specific growth rate (R2 = 0.92), and individual feed intake (R2 = 0.90). The SD600 showed higher values for hepatic somatic index according to quadratic regression (R2 = 0.95). According to quadratic regression, the highest SD had blood glucose values higher than the other SD (R2 = 0.95). Increasing SD had a positive linear effect on blood pH (R2 = 0.82) and mean corpuscular volume (R2 = 0.81) levels and a negative linear effect on hemoglobin (R2 = 0.81) and mean corpuscular hemoglobin concentration (R2 = 0.81) concentrations. In conclusion, pacu can be reared in a BFT system with an SD of 600 fish m−3 (final weight of 57.46 ± 1.60 g) since it increased the final biomass (34.16 ± 1.07 kg m−3) without compromising hematological parameters.

The Relationship Between Nutritional Anemia and Acne: A Case-Control Study.

Background In the past decade, there has been growing interest in identifying the relationship between nutritional status and acne. Many dietary factors have been studied, including milk, fast food, and chocolate. However, nutritional anemia,which is a common problem inyoung individuals, has not been well investigated. Objectives The objective of this study was to determine the relationships between acne and nutritional anemia among people in the Qassim Regionof Saudi Arabia. Methods This study used a case-control design. It targeted people aged from 15 to 25 years old in the Qassim Region of Saudi Arabia. This study was conducted using a database of Electronic Health Records (EHR) data from the Qassim University outpatient department (OPD). Data analysis was conducted by using SPSS (IBM Inc., Armonk, New York). Results A total of 114 of the study populationwere involved in this study. The acne group represented was identical to the control group. The mean age of study participants was 23.1 ± 4.19 years old, and the majority of them were females (86%). Moreover, the patient group had relatively lower levels of mean corpuscular volume (MCV), vitamin B12, ferritin, mean corpuscular hemoglobin (MCH), and hemoglobin than the control group without any significant correlation, whereas the patient group had higher levels of mean corpuscular hemoglobinconcentration (MCHC) and red cell distribution width (RDW) without significant difference. Our results showed that the prevalence of anemia among respondents was 17.5%, and a higher prevalence of anemia was observed in the control group without significant differences. Furthermore, the patient group had a significantly higher prevalence of vitamin B12 deficiency (38.6%) than the control group (p=0.041). Conclusion Our results concluded that patients with acne vulgaris in the Qassim Region of Saudi Arabia had asignificantly higher rate of vitamin B12 deficiency. Additional studies are needed to confirm this association.