Mean Corpuscular Volume Levels Research Articles

Prediction of Iron Deficiency by Red Cell Distribution Width, Mean Corpuscular Volume and Haemoglobin Concentration in Pregnant Women

Background: Red cell distribution width (RDW) is a routine parameter in fully automated hematology auto analyzer, can give the idea of iron deficiency before haemoglobin and mean corpuscular volume in early iron deficiency or latent stage. Patient can be benefited by doing complete blood count including RDW for the diagnosis of early iron deficiency as a cheaper test than iron profile. This study was aimed to predict early iron deficiency by RDW, mean corpuscular volume and haemoglobin concentration in pregnant women.
 Methods: In this study, 190 pregnant women were included from Gynae and Obstetric outdoor of Bangabandhu Sheikh Mujib Medical University from august 2008-2009. Complete blood count including haemoglobin percentage, mean corpuscular volume and RDW and iron profile were done. RDW was compared with haemoglobin concentration and mean corpuscular volume in various stages of iron deficiency.
 Results: RDW was more significant than haemoglobin concentration in latent iron deficiency when haemoglobin level was normal (p<0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though haemoglobin level was reduced. RDW was more significant than mean corpuscular volume level in latent iron deficiency, mild and moderate iron deficiency anemia. The difference of mean corpuscular volume and RDW was statistically significant (p<0.05) in latent iron deficiency, mild iron deficiency anaemia and moderate iron deficiency anaemia (p value of 0.001, 0.001 and 0.011). In this study RDW had sensitivity 82.3% and specificity 97.4%. haemoglobin concentration and mean corpuscular volume had sensitivity 56.6% and 29.2 % and specificity 90.9% and 98.7 % respectively. Based on the receiver-operator characteristic (ROC) curves RDW had the best area (0.925) under curve compared to haemoglobin and mean corpuscular volume.
 Conclusion: Latent iron deficiency without other existing disease like haemoglobinopathy, early folate / vit B12 deficiency could be predicted early by increased RDW when haemoglobin concentration and mean corpuscular volume were normal.
 Birdem Med J 2019; 9(2): 111-116

Cholelithiasis in patients with paediatric sickle cell anaemia in a Saudi hospital.

ObjectiveSickle cell disease is one of the most common inherited hemoglobinopathies in the world. Chronic haemolysis predisposes individuals to the development of bilirubinate cholelithiasis, which can be asymptomatic or can result in cholecystitis, choledocholithiasis, cholangitis, and gallstone pancreatitis. We aimed to determine the prevalence of cholelithiasis and associated gallstone disease among patients with paediatric sickle cell disease in a Saudi hospital.MethodsThis retrospective study was conducted among all patients aged between 2 and 18 years. We reviewed the medical records of patients diagnosed with sickle cell anaemia. Mean and standard deviation were calculated for quantitative variables, and the Student t-test was used to compare means. The chi-square test was used to assess those risk factors possibly associated with cholelithiasis. A P-value of ≤0.05 was considered statistically significant.ResultsApproximately 75% of participants developed cholelithiasis (27.5%) at a mean age of 6.9 ± 3.4 years. The frequency of cholelithiasis was significantly higher with increasing age (40.8% in participants 12 years and older) and among those with high levels of haemoglobin S (Hb S) and mean corpuscular volume (MCV). Moreover, cholelithiasis was more frequent among males than females, Saudis than non-Saudis, and in those with sickle cell disease than in those with sickle thalassemia. However, these differences were not statistically significant.ConclusionIn this study, the prevalence of cholelithiasis among children with sickle cell anaemia was found to be high. This association was significantly increased with age and high levels of MCV and Hb S.

Codeine-mediated Haematoxicity, Hepatotoxicity and Nephrotoxicity in Male Albino Rats

Objectives: This study aimed to investigate the effects of codeine administration on some haematological and biochemical indices in rats.
 Materials and Methods: Therapeutic dose (5 mg/kg/day), high dose (25 mg/kg/day) and extreme dose (50 mg/kg/day) of codeine were administered orally to rats for 28 days. Twenty-four hours after the last codeine administration, blood, liver and kidney were removed from the animals after an overnight fast and analysed for their haematological and biochemical parameters.
 Results: Results obtained revealed that codeine administration significantly reduced the levels of white blood cells (WBC), red blood cell (RBC) and platelet count (PLT) and increased the levels of mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV)while it resulted in non-significant changes in other haematological parameters examined when compared with control rats. Codeine intake significantly increased plasma levels of alkaline phosphatase (ALP), aspartate aminotransferase (AST), creatinine and urea while its reduced total protein levels. Hepatic and renal thiobarbituric acid reactive substances (TBARS) levels were significantly increased by codeine administration while levels of endogenous antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH) were reduced.
 Conclusions: This study confirmed the risk of increased oxidative stress, haematoxicity, hepatotoxicity and nephrotoxicity due to codeine administration. Although codeine is reported to be effective in pain management, its toxicity should be kept in mind.

Aconitum Napellus: Detoxification and Acute Toxicity Investigation Followed by Sub-Acute Toxicity and Bioavailability Assessment of Highest and Lowest LD50 Extract

In spite of high toxicological risk Aconitum napellus (ACON) is tremendously used for the treatment of rheumatoid and joint pain. The acute toxicity study was assessed for cow milk treated (CMT), goat milk treated (GMT) and water treated (WT) extracts of Aconitum napellus (ACON) in mice, expressed as LD50 (25, 50, 10 and 5 mg/kg respectively). The sub-acute toxicity of ACON (0.5 mg/kg/day) and GMT (5 mg/kg/day) were also performed in SD-rats for 28 days. The GMT not showed any treatment related changes, however ACON produced significant clinical changes in mean corpuscular volume and mean corpuscular hemoglobin level. Moreover creatinine, bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase levels significantly increased (p < 0.001), and abnormal histoarchitecture of kidney and liver were also observed as compared to control. In vivo pharmacokinetic study also confirmed that GMT constituted lesser amount of aconitine (Cmax = 1.84±1.98) than standard aconitine (Cmax = 6.82±3.1) and ACON (Cmax = 4.62±2.2). Moreover dose of GMT revealed 10 times safer than ACON. Overall processed ACON not produced any sign of toxicity at a dose dependent manner.

High Mean Corpuscular Volume Predicts Poor Outcome for Patients With Gastroesophageal Adenocarcinoma

BackgroundElevated mean corpuscular volume (MCV) is associated with a diminished prognosis for various tumor entities. This study aimed to evaluate the association between preoperative serum MCV levels and both overall (OS) and disease-free survival (DFS) for patients with resectable adenocarcinomas of the esophagogastric junction (AEG).MethodsThis study included consecutive patients undergoing surgical resection between 1992 and 2016. Measured preoperative MCV levels were stratified into quintiles and correlated with patients’ survival and clinicopathologic characteristics.ResultsThe study analyzed 314 patients with a median OS of 36.8 months and a median DFS of 20.6 months. The multivariate analysis showed that preoperatively elevated MCV is a significant prognostic factor for OS (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03–1.08; P < 0.001) and DFS (HR, 1.05; 95% CI, 1.03–1.08; P < 0.001). In the subgroup analysis of neoadjuvantly treated and untreated patients, MCV remained an independent prognostic factor for OS (HR, 1.08; 95% CI, 1.04–1.12; P < 0.001) and DFS (HR, 1.07; 95% CI, 1.03–1.12; P < 0.001) in both groups. In the univariate analysis, tumor stage and differentiation, adjuvant chemotherapy, MCV, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly correlated with diminished OS and DFS.ConclusionPreoperatively elevated MCV is an independent prognostic factor for patients with adenocarcinomas of the esophagus and the gastroesophageal junction.

Mean Corpuscular Volume and Mortality in Incident Hemodialysis Patients

Background/Aims: Anemia is common in patients with advanced chronic kidney disease (CKD). A proportion of patients present with macrocytic anemia, manifested by elevated mean corpuscular volume (MCV), which has been associated with worse outcomes in CKD patients. However, it is unknown whether elevated MCV is associated with higher mortality risk in incident hemodialysis (HD) patients. Methods: This retrospective observational cohort study examined all-cause, cardiovascular, and infectious mortality associations with both baseline and time-varying MCV in 109,501 incident HD patients using Cox proportional hazards models with 3 levels of hierarchical multivariable adjustment. Odds ratios of high versus low baseline MCV were evaluated using logistic regression. Results: The mean age of patients was 65 ± 15 (standard deviation) years and the cohort was 44% female, 58% diabetic, and 31% African American. Higher MCV was associated with older age, female sex, non-Hispanic White race-ethnicity, alcohol consumption, and having a decreased albumin or protein intake. Patients with higher MCV levels (> 98 fL) had a higher all-cause, cardiovascular, and infectious mortality risk in both baseline and time varying models, and across all levels of adjustment. In the fully adjusted models, compared to a reference of MCV 92–< 94 fL, patients with a baseline MCV > 100+ fL had a 28% higher risk of all-cause mortality (hazard ratio [HR] 1.28, 95% CI 1.22–1.34), 27% higher risk of cardiovascular mortality (HR 1.27, 95% CI 1.18–1.36), and 18% higher risk of infectious mortality (HR 1.18, 95% CI 1.02–1.38). Associations of higher MCV with these adverse outcomes persisted across all examined subgroups of clinical characteristics. Conclusions: Higher MCV was associated with higher all-cause, cardiovascular, and infectious mortality in HD patients. Further investigation is necessary to understand the underlying nature of the observed association.

The role of mean corpuscular volume change in progression of osteoarthritis

Aim: The aim of our study was to evaluate the MCV, CRP, WBC changes in OA and to research whether or not any MCV, WBC changes pronto detectable by easy complete blood count (CBC), have diagnostic values for the prediction of progression of OA. Material and Methods: Eighty-two OA and sixty-nine control patients were registered in the study. The knee OA was classified by Kellgren-Lawrence (K&L) scale. Mean corpuscular volume (MCV), white blood cell (WBC) and C-reactive protein (CRP) levels were measured. Results: CRP and MCV levels were higher in OA than the control (p=.034 and p=.022 ). Multivariable regression analysis showed that increased age, BMI, and MCV levels are unassisted associated with increased risk of advance OA (OR = 1.132, 95% CI:1.026- 1.249, p=.001; OR=1.148, 95% CI:1.062-1.242, p=.014 and OR =0.492, 95% CI: 0.259-0.937, p=.031, respectively) Conclusion: We are suggesting that instead of any complex, costly methods, easy CBC and routine biochemical parameters at the initial presentation of OA patients could also be prognostic for the likely progression of OA.

Evaluation of Immunomodulatory and Hematologic Cell Outcome in Heroin/Opioid Addicts.

The long-term use of opioids leads alternations in both innate-adaptive immune systems and other diagnostic hematologic cells. The purpose of this study is to evaluate the alterations of these parameters in patients with heroin/opioid addictions. Adults, meeting the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of the American Psychiatric Association regarding opioid use disorder (Heroin Group or HG, n = 51) and healthy controls (Control Group or CG, n = 50), were included in the study. All hematological parameters, inflammation indexes (neutrophil-lymphocyte ratio and platelet-lymphocyte ratio), and iron panel were compared with the controls. Mean corpuscular volume, red blood cell distribution width, mean corpuscular hemoglobin content, unsaturated iron-binding capacity, and total iron-binding capacity were significantly higher in HG compared to CG, while red blood cell count, hemoglobin, hematocrit, and serum iron levels were significantly lower. Additionally, platelet and platelet distribution width were significantly high while mean platelet volume was low in HG. Regarding the parameters related to immunity, white blood cell, neutrophil count, and neutrophil percentage were significantly high while lymphocyte percentage and basophils count were significantly low. Besides, inflammatory indexes were significantly higher in HG compared to CG. Intravenous administration of heroin resulted in lower levels of hemoglobin, hematocrit, and mean corpuscular volume than inhalation and intranasal administration. Our data demonstrated that chronic use of opioids is related to all of the hematologic series. The chronic use of opioid alters the immunologic balance in favor of innate immunity cells and changes the hematometric/morphometric characteristics of erythrocytes. What is more, the route of heroin administration should be taken into consideration as well. This study may lead to a better understanding of the hematological effects of heroin/opioid use in patients with relevant addictions.

Prevalence of Folic Acid Deficiency and Cost Effectiveness of Folic Acid Testing: A Single Center Experience

Study ObjectiveAccording to the National Health and Nutrition Examination Survey (NHANES) data from 2003-2006 the prevalence of folic acid deficiency in the United States has decreased from 16% to 0.5% since the dietary folic acid fortification program started in the late 1990s. Routine testing for folic acid deficiency remains quite common in the workup of anemia, dementia, alcoholism and other high risk populations. The objective for this study were to determine the prevalence of folic acid deficiency in order to analyze whether routine testing for deficiency should be discouraged or targeted to specific patient populations. In addition to this, we want to assess the economic burden that folic acid level testing adds to the high cost of care of our health system.MethodsCross sectional chart review of all adults tested for folic acid level from March 2014 to March 2015 from the Hospital and Ambulatory Care Center of the Community Hospital was undertaken. Folic acid deficiency was defined as ≤4ng/dl. Folic acid level were further classified as low (≤10ng/dl ), intermediate (10-20ng/dl) and high (>20ng/dl). Age, race, body mass index, hemoglobin, mean corpuscular volume levels and billing details were recorded of all patients and information was also collected regarding known conditions correlated to the folic acid levels including Vitamin B12 deficiency( <300 ng/dl), dementia, alcoholism, pregnancy malabsorption, sickle cell disease, bariatric surgery, inflammatory bowel syndrome, and drug therapy with HAART (Highly Active Anti-Retroviral Therapy) , TMP-SMX(Trimethoprim/sulfamethoxazole), phenytoin, valproic acid and/or methotrexate (Table 1). Statistical testing using t-test, logistic / linear regressions with α level at 0.05 was used for analysis of data.ResultsA total of 957 charts of patients who were tested for folic acid between March 2014 to March 2015 at our Heath- Care System were reviewed. 413 (43%) patients were male and 544 (57%) were female. There were 394 (41 %) Hispanics, 325 (34%) African American, 202 (21%) Caucasian and 36 (4%) were from other ethnicity. The mean age was 59.7 years and a mean Hb was 11. 6 g/ dl.Mean folic acid level was 14.5 ng/dl. 16 patients from total of 957 (2 %) had folic acid deficiency with value ≤4ng/dl . Additional results from the study are described in Table 1, Table 2 and Table 3.ConclusionThe prevalence of folic acid deficiency was 2%, About 33,000 dollars per year were used to identify such a low prevalent disease which can be treated at a low cost (2 cents/day) by oral supplementation. Low levels of folic acid were statistically associated with male sex, African American race, dementia and coexistence of vitamin B12 deficiency. Empiric supplementation of folic acid and possibly limiting testing for folic acid level to this group of patients may represent a more cost effective strategy. DisclosuresNo relevant conflicts of interest to declare.

Gradient Relationship between Increased Mean Corpuscular Volume and Mortality Associated with Cerebral Ischemic Stroke and Ischemic Heart Disease: A Longitudinal Study on 66,294 Taiwanese

The gradient relationship between mean corpuscular volume (MCV) and mortality due to ischemic vascular disease has not been researched using a large-scale population-based study. This study evaluated the association between MCV and death attributable to cerebrovascular disease (CVD) and cardiovascular disease (CAD) in a large population- and community-based Taiwanese cohort. A longitudinal study with a 9-year follow-up was conducted to evaluate individuals aged 20 years or older who had participated in the Keelung (the northernmost city in Taiwan) community-based integrated screening (abbreviated as KCIS) program since September 1999. The mortality rates associated with CVD and CAD were classified across a range of different MCV levels. Increased MCV levels were associated with an increased risk of CVD/CAD-related death (adjusted hazard ratio [aHR] = 1.42, trend test P = 0.0119). Marginally statistically significant associations were noted for specific deaths from ischemic heart disease (aHR = 1.44, trend test P = 0.0992) and cerebral ischemic stroke (aHR = 1.66, trend test P = 0.0667), respectively, but no significant gradient relationship was noted for death from cerebral hemorrhage stroke (aHR = 1.23, trend test, P = 0.6278). A gradient relationship between baseline MCV level and CVD/CAD-related death was noted, but whether such gradient relationships existed for two specific deaths and how these relationships may be confounded by extraneous factors that were not considered here should be investigated in the future.

Colorectal cancer and markers of anemia.

Unexplained iron-deficiency anemia is an important marker for colorectal cancer (CRC). Our objectives were as follows: (a) to assess whether the association between anemia and CRC can be detected on the 'Clinical Practice Research Datalink', (b) to evaluate the timing between laboratory changes and CRC detection, and (c) to analyze its association with survival. We conducted a case-control study on patients with an incident CRC diagnosis during 2008-2012 and a 1 : 1-matched control group. We compared anemia markers serum ferritin (SF), hemoglobin (Hb), mean corpuscular volume (MCV), and red blood cell count between cases and controls using conditional logistic regression. We assessed survival in CRC cases. SF values up to 20 ng/ml were associated with an odds ratio [OR (95% confidence interval)] of 10.66 (6.88-16.51) compared with SF values of 101-300 ng/ml when restricted to measurements up to 180 days before the CRC diagnosis. For measurements taken at 1 year or earlier before the diagnosis, the OR was 2.02 (1.57-2.61). For Hb values less than 9 g/dl compared with Hb values of 13.0-15.9 g/dl the corresponding ORs were 74.25 (34.69-158.91) and 2.19 (1.31-3.67), respectively. The corresponding ORs for MCV values up to 80 fl compared with MCV values of 86-95 fl were 13.94 (10.31-18.85) and 1.89 (1.51-2.36), respectively. Low levels of these markers were only weakly associated with survival. Hb, MCV, and SF levels substantially dropped only shortly before the CRC diagnosis. Although slightly more cases had anemia markers compared with controls at 1 year or earlier before the diagnosis, most cases still had normal values. The Clinical Practice Research Datalink is well-suited to detect associations between low Hb, MCV, and SF levels and CRC.

Macrocytic anemia is associated with the severity of liver impairment in patients with hepatitis B virus-related decompensated cirrhosis: a retrospective cross-sectional study

BackgroundMacrocytic anemia is common in liver disease. However, its role in hepatitis B virus (HBV)-related decompensated cirrhosis remains unknown. The aim of the present study was to determine the association between macrocytic anemia and the severity of liver impairment in patients with HBV-related decompensated cirrhosis according to the Model for End Stage Liver Disease (MELD) score.MethodsA total of 463 participants who fulfilled our criteria were enrolled in this cross-sectional study. Patients were classified into three groups according to anemia types, diagnosed based on their mean corpuscular volume level. Multivariate linear regression analyses were used to determine the association between macrocytic anemia and the MELD score for patients with HBV-related decompensated cirrhosis.ResultsPatients with macrocytic anemia had evidently higher MELD scores (10.8 ± 6.6) than those with normocytic anemia (8.0 ± 5.5) or microcytic anemia (6.3 ± 5.1). The association remained robust after adjusting for age, gender, smoking, drinking, and total cholesterol (β = 1.94, CI: 0.81–3.07, P < 0.001).ConclusionsMacrocytic anemia was found to be associated with the severity of liver impairment and might be a predictor for short-term mortality in patients with HBV-related decompensated cirrhosis.

Lipidomics as a diagnostic tool of the metabolic and physiological state of managed whales: A correlation study of systemic metabolism.

Integrating multifactor blood analysis is a key step toward a precise diagnosis of the health status of marine mammals. Variations in the circulating lipid profile reflect changes in the metabolism and physiology of an individual. To demonstrate the practicability of lipid profiling for physiological assessment, the phosphorylcholine-containing lipids in the plasma of long-term managed beluga whales (Delphinapterus leucas) were profiled using a lipidomics methodology. Using a multivariate analysis, the mean corpuscular volume, cholesterol, potassium, and γ-glutamyltranspeptidase levels were well modeled with the lipid profile of the female whales. In the models, the correlated lipids provided information about blood parameter-related metabolism and physiological regulation, in particular relating to cholesterol and inflammation. In the males, the levels of cholesterol, triglycerides, blood urea nitrogen, creatinine, plasma iron, and segmented neutrophil were well modeled with the lipid profile. In addition to providing information about the related metabolism and regulation, through a cross-linked analysis of the blood parameters, the correlated lipids indicated a parallel regulation involved in the energy metabolism of the male whales. Lipidomics as a method for revealing the context of physiological change shows practical potential for the health care of managed whales.

The impact of preoperative anaemia and anaemic subtype on patient outcome in colorectal cancer.

Preoperative anaemia is associated with adverse outcomes in colorectal cancer (CRC). To clarify the reason for this we aimed to comprehensively assess the association of preoperative anaemia with tumour characteristics, host systemic inflammation and nutrition status, and perioperative blood transfusion. We used an integrated database of 592 CRC patients. The association of preoperative anaemic subtype, calculated from haemoglobin and erythrocyte mean corpuscular volume levels, with patient outcome, preoperative serum data relating to systemic inflammation and nutrition and perioperative blood transfusion was analysed. Preoperative anaemia was significantly associated with poorer overall survival and relapse-free survival (RFS); in particular microcytic anaemia had a trend to poorer RFS than other forms of anaemia (P=0.0648). In addition, preoperative anaemia was significantly correlated with right-sided tumours, greater depth of tumour invasion, use of neoadjuvant chemotherapy, poorer prognostic nutritional index and higher modified Glasgow Prognostic Score (mGPS). Microcytic anaemia in particular had a strong association with a greater depth of tumour invasion (P=0.0072) and higher mGPS (P=0.0058) than other causes of anaemia. Perioperative blood transfusion for CRC patients with anaemia was associated with adverse outcomes. Preoperative anaemia, especially microcytic anaemia, was associated with poor patient outcomes, possibly due to poor systemic inflammatory and nutritional status, and it was not improved by perioperative blood transfusion. Our data suggest that preoperative anaemia and the anaemic subtype may serve as an easily available predictor of outcome in CRC.

Prevalence of β-Thalassemia Mutations among Northeastern Iranian Population and their Impacts on Hematological Indices and Application of Prenatal Diagnosis, a Seven-Years Study.

Background and Objectiveβ-thalassemia results from a diverse range of mutations inside the hemoglobin subunit β (HBB) gene. In a study of β-thalassemia carriers and some of their at-risk fetuses in the Khorasan province of Iran, we aimed to recognize the most common mutations in the region. We also investigated a possible link between these mutations and some of the relevant hematological indices.MethodsAmplification-refractory mutation system-PCR (ARMS-PCR) was used to detect the typical HBB mutations among 1593 individuals, suspected of having a mutated HBB allele from March/2011 to January/2018. Sanger sequencing of HBB had been performed, where ARMS-PCR was uninformative. In some cases, reverse dot blot was utilized. Analysis of variance was used to compare parametric variables.ResultsAmong 1273 β-thalassemia carriers, the prevalence of the mutations were reported as follows: IVS-I-5 (42.03%), IVS-II-1 (11.23%), codons 8/9 (4.79%), codon 44 (4.56%), codon 15 (3.53%), Los Angeles (2.91%), codon 5 (2.75%), IVS-I-110 (2.51%), −88 (2.20%) and other mutations were less than 2% of all of the reported mutations. 644 conceptions were subjected to prenatal diagnosis, using chorionic villus sampling. 118 cases were reported as normal. 352 cases were detected as carriers. 174 cases were diagnosed as affected. There was a significant difference in mean corpuscular volume and hemoglobin A2 levels between the nine most commonly reported mutation types (p<0.001).ConclusionThis study makes a reliable guide for β-thalassemia diagnosis in the region. The possibility of a correlation between HBB mutations and hematological indices opens a gate of future investigations.

First Report of β-Thalassemia Intermedia in a Patient Compound Heterozygous for –92 (C>T) and Codons 36/37 (–T) Mutations

The –92 (C>T) (HBB: c.-142C>T) is a silent β-thalassemia (β-thal) mutation previously described in combination with several β0 mutations and expressed as β-thal intermedia (β-TI). Heterozygous individuals are known to be completely asymptomatic showing borderline hemoglobin (Hb), mean corpuscular volume (MCV) and Hb A2 levels. Here, we report the first incidence of –92 in Eastern Europe and in Azerbaijan, and the first case in combination with codons 36/37 (–T) (HBB: c.112delT) mutation.

Hematological dynamics following the co-administration of Resveratrol and Cisplatin in Sprague–Dawley rats.

Background: Cisplatin, a platinum-based chemotherapy agent, is used in the effective treatment of a wide range of malignant cancers. Resveratrol, a polyphenolic plant-derived compound, has been shown to have several biological effects including protecting the body against several forms of damages. Objective: This study assessed the effects of cisplatin and supplementation with resveratrol on some hematological parameters in Sprague-Dawley rats. Material and Methods: Forty-five adult female Sprague–Dawley rats, grouped into 9, were used for this experimental study. Group 1 served as the control group and received distilled water only. Groups 2 and 9 received Cisplatin only while groups 3, 4, and 5 received different doses of Resveratrol after a single dose of Cisplatin. Groups 6, 7, and 8 received Resveratrol before Cisplatin. Results: At the end of administration, blood samples were collected and different hematological parameters were accessed. Groups 2 and 5 showed a significantly higher Total WBC when compared to the control group (p<0.05). Group 7 showed a significantly higher (p<0.05) neutrophil count compared to both the control group and group 2, but a significant decrease in the lymphocyte count compared to the same groups (p<0.05). Groups 6 and 7 showed a significant reduction in monocyte when compared to the control group (p<0.05). There was no significant difference in the eosinophil count of all treatment groups when compared to the control group and cisplatin groups (p<0.05). Basophil increased significantly in group 7 when compared to the control group and group 2 (p<0.05). More so, a significant decrease in the Haemoglobin (Hb), Packed cell volume (PCV) and Mean corpuscular volume (MCV) level were observed when compared to group 9 (p<0.05). Conclusion: This study showed that cisplatin-induced alteration in some hematological parameters is reversible by treatment with resveratrol. More so, resveratrol supplementation should be incorporated as part of dietary nutrients for patients on cisplatin during chemotherapy.

The Effect of Dietary Candlenut Powder on Blood Profile and Meat Cholesterol Content of Broilers

ABSTRACT. The purpose of this research was to investigate the use of candlenut powder (Aleurites mollucana (L.) Willd.) as feed additive on blood profile and meat cholesterol content of broilers. Materials used in this research were 200 day-old broiler chicks. Research method was in vivo on Completely Randomized Design with 5 treatments (P0 = basal diets only, P1 = basal diets + 0.25% candlenut powder, P2 = basal diets + 0.5% candlenut powder, P3 = basal diets + 0.75% candlenut powder, P4 = basal diets + 1% candlenut powder), each treatment was replicated 5 times. Variables measured were blood profile (erythrocyte, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin) and meat cholesterol content. Data were analyzed by using Analysis of Variance. Data with significant different effects were further analyzed by using Duncan’s Multiple Range Test. The results showed that candlenut powder usage as feed additive had a highly significant effect on (P0.01) erythrocyte and hemoglobin levels. Candlenut powder also significantly affect (P0.05) mean corpuscular hemoglobin (MCH), but did not significantly affect (P0.05) mean corpuscular volume (MCV) levels. Broilers fed candlenut powder had lower (P0.01) meat cholesterol content compared to those fed basal diets only. It might be concluded that the use of candlenut powder as feed additive at the level of 1% is safely recommended to give better blood profile and reduce meat cholesterol content of broilers.Pengaruh penambahan tepung biji kemiri terhadap profil darah ayam pedaging dan kandungan kolesterol dagingABSTRAK. Tujuan penelitian ini untuk mengevaluasi pemanfaatan tepung biji kemiri (Aleurites mollucana (L.) Willd.) sebagai aditif pakan terhadap profil darah dan kandungan kolesterol daging ayam pedaging. Materi yang digunakan adalah 200 ekor day old chicks (DOC) ayam pedaging. Metode penelitian menggunakan percobaan in vivo pada Rancangan Acak Lengkap (RAL) dengan 5 perlakuan (P0 = pakan basal, P1 = pakan basal + 0.25% tepung biji kemiri, P2 = pakan basal + 0.5% tepung biji kemiri, P3 = pakan basal + 0.75% tepung biji kemiri, P4 = pakan basal + 1% tepung biji kemiri), setiap perlakuan diulang sebanyak 5 kali. Data dianalisis menggunakan analisis variansi (ANOVA) perbedaan yang signifikan dilanjutkan dengan Uji Jarak Berganda Duncan’s. Hasil penelitian menunjukkan bahwa pemanfaatan tepung biji kemiri sebagai aditif pakan memberikan perbedaan yang sangat nyata (P0,01) terhadap jumlah eritrosit dan hemoglobin. Tepung biji kemiri juga memberikan pengaruh yang nyata (P0,05) terhadap mean corpuscular hemoglobin (MCH), tetapi tidak memberikan pengaruh yang nyata terhadap mean corpuscular volume (MCV) darah ayam. Ayam pedaging yang diberi pakan dengan penambahan tepung biji kemiri memiliki kandungan kolesterol daging yang lebih rendah (P0,01) dibandingkan dengan yang hanya diberi pakan basal. Kesimpulan dari penelitian ini adalah bahwa penambahan tepung biji kemiri sebanyak 1% dapat memberikan profil darah yang lebih baik dan efektif untuk menurunkan kandungan kolesterol daging ayam pedaging.ABSTRACT. The purpose of this research was to investigate the use of candlenut powder (Aleurites mollucana (L.) Willd.) as feed additive on blood profile and meat cholesterol content of broilers. Materials used in this research were 200 day-old broiler chicks. Research method was in vivo on Completely Randomized Design with 5 treatments (P0 = basal diets only, P1 = basal diets + 0.25% candlenut powder, P2 = basal diets + 0.5% candlenut powder, P3 = basal diets + 0.75% candlenut powder, P4 = basal diets + 1% candlenut powder), each treatment was replicated 5 times. Variables measured were blood profile (erythrocyte, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin) and meat cholesterol content. Data were analyzed by using Analysis of Variance. Data with significant different effects were further analyzed by using Duncan’s Multiple Range Test. The results showed that candlenut powder usage as feed additive had a highly significant effect on (P0.01) erythrocyte and hemoglobin levels. Candlenut powder also significantly affect (P0.05) mean corpuscular hemoglobin (MCH), but did not significantly affect (P0.05) mean corpuscular volume (MCV) levels. Broilers fed candlenut powder had lower (P0.01) meat cholesterol content compared to those fed basal diets only. It might be concluded that the use of candlenut powder as feed additive at the level of 1% is safely recommended to give better blood profile and reduce meat cholesterol content of broilers.

Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.

Vitamin B12 deficiency is common, and the incidence increases with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular (IM) vitamin B12. Doctors may not be prescribing oral vitamin B12 formulations because they may be unaware of this option or have concerns regarding its effectiveness. To assess the effects of oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. We searched CENTRAL, MEDLINE, Embase, and LILACS, as well as the WHO ICTRP and ClinicalTrials.gov. The latest search date was 17 July 2017. We applied no language restrictions. We also contacted authors of relevant trials to enquire about other published or unpublished studies and ongoing trials. Randomised controlled trials (RCTs) comparing the effect of oral versus IM vitamin B12 for vitamin B12 deficiency. We used standard methodological procedures expected by Cochrane. Our primary outcomes were serum vitamin B12 levels, clinical signs and symptoms of vitamin B12 deficiency, and adverse events. Secondary outcomes were health-related quality of life, acceptability to patients, haemoglobin and mean corpuscular volume, total homocysteine and serum methylmalonic acid levels, and socioeconomic effects. We used GRADE to assess the quality of the evidence for important outcomes. We did not perform meta-analyses due to the small number of included trials and substantial clinical heterogeneity. Three RCTs met our inclusion criteria. The trials randomised 153 participants (74 participants to oral vitamin B12 and 79 participants to IM vitamin B12). Treatment duration and follow-up ranged between three and four months. The mean age of participants ranged from 38.6 to 72 years. The treatment frequency and daily dose of vitamin B12 in the oral and IM groups varied among trials. Only one trial had low or unclear risk of bias across all domains and outcome measures. Two trials reported data for serum vitamin B12 levels. The overall quality of evidence for this outcome was low due to serious imprecision (low number of trials and participants). In two trials employing 1000 μg/day oral vitamin B12, there was no clinically relevant difference in vitamin B12 levels when compared with IM vitamin B12. One trial used 2000 μg/day vitamin B12 and demonstrated a mean difference of 680 pg/mL (95% confidence interval 392.7 to 967.3) in favour of oral vitamin B12. Two trials reported data on adverse events (very low-quality evidence due to risk of performance bias, detection bias, and serious imprecision). One trial stated that no treatment-related adverse events were seen in both the oral and IM vitamin B12 groups. One trial reported that 2 of 30 participants (6.7%) in the oral vitamin B12 group left the trial early due to adverse events. Orally taken vitamin B12 showed lower treatment-associated costs than IM vitamin B12 in one trial (low-quality evidence due to serious imprecision). No trial reported on clinical signs and symptoms of vitamin B12 deficiency, health-related quality of life, or acceptability of the treatment scheme. Low quality evidence shows oral and IM vitamin B12 having similar effects in terms of normalising serum vitamin B12 levels, but oral treatment costs less. We found very low-quality evidence that oral vitamin B12 appears as safe as IM vitamin B12. Further trials should conduct better randomisation and blinding procedures, recruit more participants, and provide adequate reporting. Future trials should also measure important outcomes such as the clinical signs and symptoms of vitamin B12 deficiency, health related-quality of life, socioeconomic effects, and report adverse events adequately, preferably in a primary care setting.

Methotrexate therapy impacts on red cell distribution width and its predictive value for cardiovascular events in patients with rheumatoid arthritis

BackgroundMethotrexate (MTX) is well known to affect folic acid metabolism, so MTX treatment can result in alterations of mean corpuscular volume (MCV), which may impact on red cell distribution width (RDW), as MCV levels feed into RDW calculation. We thus questioned whether RDW levels and subsequently its diagnostic utility in RA subjects, as reported before, are influenced by ongoing MTX therapy.We assessed the impact of disease modifying drug (DMARD) treatment, especially MTX, on RDW and evaluated their influence on the predictive value of RDW for cardiovascular (CV) events in patients with rheumatoid arthritis (RA). As far as we know, this is the first study evaluating the influence of MTX on RDW.MethodsMedical treatment, disease activity, laboratory parameters and history of CV events were retrospectively analysed in 385 RA patients at disease onset and at last follow up at our clinic. Additionally, in patients with CV event, data were recorded at last follow up prior the CV event.ResultsDisease parameters and laboratory findings associated with a serious vascular event were older age (p < 0,001), longer disease duration (p = 0,002) and a higher RDW at diagnosis (p = 0,025). No differences in RDW levels became evident with any other treatment regimen beside MTX. MTX treated patients had significantly higher RDW compared to subjects without this drug (p < 0,001). In RA patients without MTX treatment, we found RDW level significantly different between those with versus without a CV event, whereas this difference disappeared in subjects receiving MTX.ConclusionMTX impacts on RDW and might therefor reduce its prognostic value for CV events in patients taking MTX, whereas an increased RDW at diagnosis remains an early risk predictor for myocardial infarction and stroke in RA patients.