Microcytic Anemia Research Articles

Anemia among dogs within Maiduguri, Northeastern Nigeria; A Retrospective Approach

Anemia causes morbidity and mortality in dogs and it is one of the signs of disease in this species. Anemia can occur because of decrease or defective production of red blood cells, acute or chronic blood loss or due to intravascular hemolysis, extravascular hemolysis or both. The records of dogs presented for routine checkup at the Veterinary Teaching Hospital, University of Maiduguri was evaluated from 2015-2021 for diagnosed cases of anemia based on routine hematology. A total of 73 dog files were sorted out from the records. Fifty-three (53) dogs were found to be anemic (72.6%), while 20 (27.4%) were non-anemic. Puppies tend to have the microcytic hypochromic anemia possibly due to iron deficiency, while adult dogs had the macrocytic normochromic anemia. Anemia was more prevalent in male dogs than female dogs, probably due to movement of the males during mating season, thereby exposing them to risks of ecto and endo parasitism. In conclusion anemia is prevalent amongst dogs in Maiduguri metropolis, hence there is a need for further studies to identify and characterize the possible etiologies.

Case report: Multiple autoimmune syndrome

This is a case of multiple autoimmune syndrome with the co-occurrence of vitiligo, pernicious anemia, celiac disease and autoimmune hepatitis is extremely rare. We are presenting a case is a 40-year-old woman with autoimmune hepatitis who is suffering from poor appetite, weight loss and skin lesions. Laboratory investigation shows hypochromic microcytic anemia, B12, and iron deficiency. The testing for parietal cell antibody was positive so pernicious anemia was diagnosed with positive Tissue transglutaminase antibody IgA so the diagnosis of celiac disease was confirmed.

Prevalence of microcytic hypochromic anemia and their assosiated risk factor among female students of Sarhad University Peshawar, Pakistan

Microcytic hypochromic anemia which is a type of blood condition in which the cells become paler and smaller than they should be and it is caused by many reasons that include nutritional deficiencies. Material and methods: It were a descriptive analytical and cross-sectional study conducted at Sarhad University Peshawar, Pakistan that included 50 females. This study was performed in the duration of four months. All the females who were pregnant students, those with prior diagnoses, and thalassemia-positive cases were excluded. Results: Within these 50 participants, the income groups were categorized showing a 35% prevalence of hypochromic microcytic anemia in the 40k-50k income group and 8.5% in the above 50k group. Stress groups showed a 20% prevalence of hypochromic microcytic anemia in those experiencing stress compared to 13.3% in the non-stress group, forming a basis for comparisons in our research analysis with 44 anemia-familiar participants and 6 non familiar participants. Conclusion: more anemia cases, specifically microcytic hypochromic anemia, were seen in higher-income families, especially those with incomes between 40k to 50k; Stress also seemed to play a role, as stressed students had a higher likelihood of having this type of anemia, highlighting the complex relationship between income, stress, and anemia prevalence.

Liver Abscess Management in a Complex Oncologic Case

Liver abscesses pose a significant clinical challenge, particularly when complicated by underlying conditions such as cholangiocarcinoma. This case report describes the management of a complex, multiloculated liver abscess in a 50-year-old patient with a multifaceted medical history. A 50-year-old female with a history of cholangiocarcinoma and associated complications presented with progressive odynophagia and chest pain amidst a backdrop of multiple comorbidities, including diabetes mellitus, gastrointestinal disorders, and a complex surgical history. On admission, she exhibited tachycardia, hypertension, and laboratory findings indicative of microcytic anemia, electrolyte imbalances, and potential systemic hypoperfusion. Imaging did not reveal acute cardiopulmonary issues. Treatment for E. coli bacteremia and suspected liver abscess included antibiotics and percutaneous drainage with substantial purulent discharge. The patient’s care was further complicated by oral thrush and esophagitis managed successfully with antifungals. Palliative care was consulted. On day 34, the patient was discharged to home hospice. This case supports the use of percutaneous drainage as a frontline treatment for multiloculated liver abscesses and underscores the need for individualized treatment approaches. It also emphasizes the role of interventional radiology in managing complex intra-abdominal infections.

Perbedaan Parameter Eritrosit Dan Retikulosit Pada Pasien Talasemia Beta Minor Dan Anemia Defisiensi Besi Ringan

Beta thalassemia and iron deficiency anemia (IDA) are most common microcytic hypochromic anemia. It is difficult to distinguish minor β thalassemia from mild iron deficiency anemia only by clinical findings and routine hematology examinations, it requires confirmatory tests which are limited in availability and relatively expensive. The presence of additional erythrocyte and reticulocyte parameters (RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, IRF) in hematology analysers are expected to be screening parameters in differentiating minor β thalassemia from mild IDA. The purpose of this study was to determine the differences in the values ​​of RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, and IRF between minor β thalassemia patients and mild IDA. This study was an observational, analytical, comparative, with a cross sectional design. Research was conducted at RSU Kota Tangerang Selatan from July to October 2020. Subjects were children who went to an outpatient clinic/medical check-up, or with laboratory data of minor β thalassemia or had β thalassemia families. Samples were analysed using Sysmex XN 1000. Statistical analysis was performed by the independent t test for normally distributed data and the Mann Whitney difference test for abnormally distributed data. The RBC-He and Ret-He values ​​were lower in minor β thalassemia than mild IDA and significantly different with p value 0.005 and 0.004, respectively. The %MicroR and %Hypo-He values were higher in minor β thalassemia than mild IDA and significantly different with p values ​ 0.000 and 0.003, respectively. The RDW-CV and IRF values ​​were higher in minor β thalassemia than mild IDA but were not significantly different with the p value 0.076 and 0.528 respectively. Conclusion: RBC-He and Ret-He values which reflect hemoglobin content in erythrocytes and reticulocytes ​​were lower in minor β thalassemia patients compared to mild IDA and were significantly different. The values ​​of %MicroR and %Hypo-He which reflect microcytic and hypochromic in erythrocyte population were higher in patients with minor β thalassemia than mild IDA and were significantly different. RDW-CV which reflects variation size of erythrocytes and IRF which reflects erythropoiesis activity and ineffective erythropoiesis were higher in patients with minor β thalassemia than mild IDA and were not significantly different.

Validity of Mentzer Index in Predicting Iron Deficiency Anaemia

Objective: To determine the diagnostic accuracy of the Mentzer index as a screening tool for iron deficiency anaemia, using an iron profile as the gold standard in patients presenting with hypochromic microcytic anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to May 2022. Methodology: Data was collected from 163 patients with hypochromic microcytic anaemia. Red cell indices were noted for each patient and recorded on a defined proforma. Results: The mean age of the patients was 8.23±3.57 years. 85(52.1%) patients were males and 78(47.9%) were females. Moreover, out of 163 patients, the specificity, sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of the Mentzer index for the diagnosis of iron deficiency anaemia were 90.1%, 90.1%, 84.6%, 93.8%, and 90.8%, respectively. Conclusion: The cell-count-based indices, especially the Mentzer index, are reliable and available methods for diagnosing iron deficiency anaemia. They have an accurate discrimination ability.

Hypertension Increases Susceptibility to Experimental Malaria in Mice.

Global prevalence of hypertension is on the rise, burdening healthcare, especially in developing countries where infectious diseases, such as malaria, are also rampant. Whether hypertension could predispose or increase susceptibility to malaria, however, has not been extensively explored. Previously, we reported that hypertension is associated with abnormal red blood cell (RBC) physiology and anemia. Since RBC are target host cells for malarial parasite, Plasmodium, we hypothesized that hypertensive patients with abnormal RBC physiology are at greater risk or susceptibility to Plasmodium infection. To test this hypothesis, normotensive (BPN/3J) and hypertensive (BPH/2J) mice were characterized for their RBC physiology and subsequently infected with Plasmodium yoelii (P. yoelii), a murine-specific non-lethal strain. When compared to BPN mice, BPH mice displayed microcytic anemia with RBC highly resistant to osmotic hemolysis. Further, BPH RBC exhibited greater membrane rigidity and an altered lipid composition, as evidenced by higher levels of phospholipids and saturated fatty acid, such as stearate (C18:0), along with lower levels of polyunsaturated fatty acid like arachidonate (C20:4). Moreover, BPH mice had significantly greater circulating Ter119+ CD71+ reticulocytes, or immature RBC, prone to P. yoelii infection. Upon infection with P. yoelii, BPH mice experienced significant body weight loss accompanied by sustained parasitemia, indices of anemia, and substantial increase in systemic pro-inflammatory mediators, compared to BPN mice, indicating that BPH mice were incompetent to clear P. yoelii infection. Collectively, these data demonstrate that aberrant RBC physiology observed in hypertensive BPH mice contributes to an increased susceptibility to P. yoelii infection and malaria-associated pathology.

Bone marrow histology of cytopenias : Contribution to hematological differential diagnosis

Besides microscopic evaluation of smears, flow cytometric analysis, chromosomal and molecular studies, histological analysis of bone marrow biopsies (BMbx) is animportant component of multiparameter diagnostics of cytopenias in hematology. More than in other fields of histopathology, correct interpretation of BMbx requires correlation with the results of these further studies and other clinical findings. Microcytic, normocytic and macrocytic anemia, isolated granulocytopenia and thromobocytopenia as well as pancytopenia represent frequent and recurrent diseases. With regard to aetiology, reactive and neoplastic causes must be differentiated. Reactive causes of cytopenia include substrate deficiencies, enhanced turn over and loss, and inflammatory processes. Neoplastic disorders with the exception of myeloproliferative neoplasms generally manifest as cytopenia and comprise myelodysplastic syndromes (MDS), acute myeloid leukemia (AML) and lymphoma.

Haemoglobin lepore and beta thalassaemia traits – Prenatal testing by both sequence analysis and MLPA for HBB gene: A case report

Hb Lepore is a fusion globin protein made of fused chains of delta and beta globin. It is a deletion haemoglobinopathy. In homozygote form, it is similar to transfusion dependent beta thalassaemia major, and in the heterozygous form, it causes mild microcytic hypochromic anaemia. In this case report, the couple has heterozygous Hb Lepore and heterozygous beta thalassaemia, with a pregnancy of 15weeks gestation. Prenatal testing by amniocentesis and HBB gene analysis for the fetus was done by sequencing and MLPA to detect the different types of mutations present in the parents. This case report reveals the importance of MLPA to be done along with sanger sequencing, to detect all types of mutations in the HBB gene.

A178 GASTROINTESTINAL STRICTURES IN A PEDIATRIC PATIENT WITH SATOYOSHI SYNDROME

Abstract Background Satoyoshi syndrome (SS) is a rare, progressive, multisystem disease including muscle spasms, alopecia, skeletal deformities, and diarrhea, with suspected autoimmune etiology. Treatment includes corticosteroids, immunoglobulin therapy, or immunosuppression. Reported endoscopic findings include loss of intestinal folds and nodularity in the stomach and the intestine, with histology showing gastritis cystica polyposa and lymphoplasmacytic infiltrate, as well as fibrosis noted on autopsy reports. To date, no cases of intestinal stricture have been described in SS. Aims To describe an original case of intestinal strictures in SS. Methods Case report and literature review. Results We present a case of a 10-year-old girl with chronic diarrhea and intermittent hematochezia, postprandial abdominal pain, intermittent non-bilious emesis, stunted growth, and weight loss, with acquired alopecia and severe muscle cramps. Examination showed a non-dysmorphic, small child with alopecia totalis and a distended, tender abdomen. Investigations demonstrated an unremarkable endocrine work-up, mild hypoalbuminemia, microcytic anemia, and anti-transglutaminase serology at 3-4x ULN with no improvement on the gluten-free diet. Endoscopy identified a duodenal stricture with a very distended stomach and duodenal bulb, mucosal nodularity and bridging creating a web-like appearance, and edema and friability of the left-sided colon. MR enterography confirmed an isolated duodenal stricture. Pathology displayed patchy fibrosis with crypt/glandular dilatation in the antrum, duodenum, and rectum. Skeletal imaging detected physeal widening and sclerosis with mild slipping of the epiphyses. Auto-immune markers included positive ENA profile for anti-Sm, anti-Sm/RNP, and anti-RNP-A. The patient was treated with corticosteroids in addition to a series of endoscopic dilatations for duodenal stricture with symptomatic benefit, with addition of upadacitinib for alopecia management. Follow-up revealed intermittent worsening of symptoms with steroid taper, necessitating further duodenal dilatations, and evidence of a new anal stricture. The patient remains on corticosteroid therapy with ongoing surveillance. Conclusions This case identifies the first report of intestinal strictures in SS, which may suggest that in addition to suspected autoimmune pathogenesis, disorders of fibrogenesis may need to be considered. Funding Agencies None

A74 A RARE CASE OF ANTIDEPRESSANT-INDUCED LYMPHOCYTIC COLITIS IN A TEENAGER

Abstract Background The etiopathogenesis of microscopic colitis may reflect an immunological reaction in genetically predisposed individuals exposed to an external stimulus causing gut microbiota disruption. Numerous factors such as smoking, autoimmune diseases, and medications have been linked to this condition in adults. Steroids may be required as therapy. Pediatric cases of microscopic colitis have only rarely been reported. Aims Case report. Methods Retrospective single chart review and literature review of microscopic colitis in children. Results A 17-year-old female newly diagnosed with major depression disorder following intentional acetaminophen intoxication was started on sertraline, a selective serotonin reuptake inhibitor (SSRI). Within 2 months from initiation, she began to have non bloody watery diarrhea and had a 5 kg weight loss over a 1-month period . Her laboratory workup only revealed a hypochromic, microcytic anemia. Due to severity of symptoms and reluctance of treating team to discontinue sertraline, she underwent an esophagogastroduodenoscopy and ileo-colonoscopy, both showing grossly normal mucosa. Histological assessment of the colon demonstrated increased intraepithelial lymphocytes, up to 50-60 lymphocytes/100 enterocytes (normal ≤ 20 lymphocytes/100 enterocytes), with associated reactive superficial epithelial changes including goblet cell and mucin depletion, compatible with lymphocytic colitis (Figure1). Sertraline was weaned off, and gastrointestinal symptoms resolved completely. A repeat sigmoidoscopy 5 months later confirmed complete normalization of the histology. Conclusions Microscopic Colitis encompasses two disorders, lymphocytic colitis and collagenous colitis, in which the endoscopic appearance is unremarkable, but histological changes are diagnostic. The clinical manifestations of both are similar and typically include chronic non bloody watery diarrhea, weight loss and abdominal pain. Certain medications have been implicated in causing lymphocytic colitis, including SSRIs. SSRIs historically have not been frequently prescribed in pediatrics, but their use has increased in recent years. The complete resolution of symptoms and histology, without the need for any medical therapy, strongly supports that this lymphocytic colitis was caused by sertraline. The association of lymphocytic colitis with sertraline is not well-known among pediatric practitioners: neither the pediatrician nor psychiatrist in our case were aware of such a possibility. This case highlights that medication adverse events, even if rare, should always be considered when chronology is supportive, and at times, simple discontinuation of the drug is sufficient to completely resolve the issue. Funding Agencies None

Validity of Erythrocyte Indices in Differentiation between Iron Deficiency Anemia and β-Thalassemia Trait in Children

Iron deficiency anemia (IDA) and β-thalassemia trait (BTT) are the most common causes of hypochromic microcytic anemia (HMA). Various erythrocyte indices that may help in the initial discrimination between IDA and BTT have been reported, but data evaluating their reliability in children are scarce. We aimed to evaluate the validity of 12 erythrocyte indices in the differentiation between IDA and BTT in children. These indices were red blood cell (RBC) count, Mentzer Index, England and Fraser Index, Srivastava Index, Shine and Lal Index, RBC distribution width (RDW), Ricerca Index, Green and King Index, RDW Index, Sirdah Index, Ehsani Index, and Serdar Index. Among 1,444 children with HMA, 136 (9.4%) were stratified into the IDA group and 137 (9.5%) into the BTT group. Of the 12 indices, the Green and King Index showed the highest reliability, as it had the highest Youden’s index (75.1%). Its sensitivity, specificity, positive predictive value, negative predictive value and correct diagnosis rate were 92.7%, 82.4%, 84.1%, 91.8% and 87.5%, respectively. The second most reliable index was the RDW Index, having a Youden’s index, sensitivity, specificity, positive predictive value, negative predictive value and correct diagnosis rate of 64.0%, 94.2%, 69.9%, 75.9%, 92.2% and 82.0%, respectively. Receiver operating characteristic analysis showed that the revised cut-off values for the Green and King Index and RDW Index had higher sensitivity and specificity levels than the cut-off values commonly used in the literature. The findings of this study suggest the superiority of the Green and King Index and the RDW Index as screening tools in the initial differentiation between IDA and BTT among children with HMA.

Comprehensive Genomic Analysis Identifies a Diverse Landscape of Sideroblastic and Nonsideroblastic Iron-Related Anemias with Novel and Pathogenic Variants in an Iron-Deficient Endemic Setting

Inherited iron metabolism defects are possibly missed or underdiagnosed in iron-deficient endemic settings due to a lack of awareness or a methodical screening approach. Hence, we planned a systematic evaluation of anemia cases (2019-2021) based on clinical phenotype, normal screening tests (HPLC, alpha gene sequencing, ESR, CRP, tTG), and abnormal iron profile by targeted NGS (26 gene-panel) supplemented with whole exome, MLPA/mtDNA sequencing and CMA. Novel variants in ALAS2, STEAP3, and HSPA9 genes were functionally validated. 290 anemia cases were screened and 41 (14%) enrolled for genomic testing as per inclusion criteria. Comprehensive genomic testing revealed pathogenic variants in 23/41 (56%) cases. Congenital sideroblastic anemia (CSA) was the most common diagnosis (14/23;61%) with pathogenic variations in ALAS2 (6), SLC25A38 (3), HSPA9 (2) and HSCB, SLC19A2 and mtDNA deletion (1 each). Non-sideroblastic iron defects included STEAP3-related microcytic anemia (2/23;8.7%) and hypotransferrenemia (1/23;4.3%). 6/22 (27%) revealed a non-iron metabolism gene defect on whole exome sequencing. A total of 11 novel variants (including VUS) were noted in 13 cases. Genotype-phenotype correlation revealed a significant association of frameshift/nonsense/splice variants with lower presentation age (0.8 months vs. 9 years; p-<0.01) compared to missense variants. The systematic evaluation helped uncover an inherited iron defect in 41% (17/41) cases, suggesting the need for active screening and awareness for these rare diseases in an iron deficient endemic population.

Diagnosis and treatment of Ehrlichiosis in a Pug dog

In addition to damaging the skin and causing inflammatory reactions and anemia, dog tick infestations are vectors for blood parasites such as Ehrlichia spp., known as Ehrlichiosis. This article reports the case of a five-year-old female Pug dog whose body was covered with ticks. The clinical examination found tick infestation on the face, ears, back, abdomen, legs, and interdigital areas. Supporting examinations included a complete blood count (CBC), buffy coat smear, and a test kit. CBC examination showed that the dog had leukocytosis, neutrophilia, hypochromic microcytic anemia, and thrombocytopenia. A buffy coat smear examination showed the presence of Ehrlichia morulae in the cytoplasm of the dog's monocytes, and the test kit results were positive for Ehrlichia antibodies; therefore, the dog was diagnosed with Ehrlichiosis. Treatment is done by administering Doxycycline, Intervetta Dr. Choice Ferro-B, and Fu Fang Ejiao Jiang orally for 21 days. After treatment, hematological parameters in leukocytes, neutrophils, erythrocytes, and platelets returned to normal ranges.

A Prospective Observational Study of the Prevalence, Risk Factors, Management and Types of Anaemia in Hospitalized Patients in Surat, India

Background: Anaemia is a common condition in hospitalized patients and is associated with adverse clinical outcomes, such as increased morbidity, mortality, and length of hospital stay. However, there is limited research on the prevalence, types, risk factors, and management of anaemia in Surat, India. Methods: We conducted a prospective observational study of 407 hospitalized patients in Surat, India, to investigate the prevalence, types, risk factors, and management of anaemia. Data were collected through case report forms. Hemoglobin levels were used to diagnose anaemia, and the World Health Organization (WHO) criteria were used to classify the severity of anaemia. Results: The results showed that the prevalence of anaemia was highest in the pediatric ward, with microcytic normochromic anaemia being the most common type of anaemia in male and female patients. Moderate anaemia was found to be the most common among the study population. The majority of patients were transfused with RBC for severe anaemia. Conclusion: The findings of this study have implications for the management of anaemia in hospital populations, highlighting the need for targeted interventions for different patient groups and emphasizing the need for improved screening and management of anaemia, particularly in high-risk populations such as pediatric and female patient.

Diagnostic Utility of Reticulocyte Hemoglobin Equivalent Parameter in the Evaluation of Microcytic Hypochromic Anemia – Our Experience from Northeast India

Background: Reticulocytes are red blood cell precursors with an average lifespan of 1–2 days. Reticulocyte hemoglobin equivalent (Ret-He) is an early marker of iron deficiency (ID) erythropoiesis and reflects real-time information regarding the synthesis of young erythrocytes in the bone marrow. The objective of this study is to determine the diagnostic utility of Ret-He in patients having microcytic hypochromic anemia in comparison with serum ferritin and iron studies. Objectives: The objective of this study is to determine the diagnostic utility of the Ret-He parameter in patients having microcytic hypochromic anemia in comparison with the serum ferritin, iron studies and its role in routine hematological screening for nutritional deficiency anemia like ID. Design and Settings: The design involves observational study. Materials and Methods: A hospital-based observational study was carried out in a referral hospital. Hematological parameters were processed using Sysmex XN1000 (Sysmex Corporation, Kobe, Japan) analyzer and were compared with Serum iron studies using biochemistry analyzer (VITROS® 250 Chemistry System) from 201 participants who presented with microcytic hypochromic anemia. Main Outcome and Measures: Relationship of Ret-He parameter and its diagnostic utility for screening of iron-deficient states. Sample Size: The sample size was 201. Results: When serum ferritin is taken as “the gold standard” to detect ID, with Ret-He cutoff of 27.15 pg/cell, we found a statistically significant positive correlation between Ret-He and serum ferritin (P &lt; 0.001). We found a sensitivity of 57.37% and specificity of 75.95% with area under the curve of 0.681, positive predictive value of 100%, negative predictive value of 3.8%, and accuracy of 62.19% for Ret-He in detecting ID anemia (IDA). Also found a statistically significant negative correlation between Ret-He and total iron binding capacity (P &lt; 0.001). There was no statistical correlation between Ret-He and serum iron levels in our study. Conclusions: The present study suggests Ret-He is one of the better and more reliable hematological parameters indicating ID and, when used along with biochemical parameters like serum ferritin, can give valuable inputs in a better screening and diagnosis of IDA; hence proper treatment is possible. Limitations: The multicentric study is required to standardize Ret-He reference values, and follow-up to therapy of the subjects was not done. Additional hemoglobin variant analysis data would have been favorable to the study.

Case report: Demodicosis in a Chow-chow dog at Yours Veterinary Clinic in Padang Panjang City

Demodecosis, also known as Red Mange, Acarus Mange, and Follicular Mange, is a skin disease caused by the mite Demodex canis. Demodecosis infection can occur in dogs of all ages. This study aims to diagnose and treat the infection of Demodex sp in chow-chow dogs. Clinical signs include generalized alopecia, scales, and crusts found on the body's surface, followed by dehydration symptoms, poor skin turgor, and long CRT. Supporting examinations to determine demodecosis infection are carried out using the deep skin scrapping test method. Next, a hematological exam was carried out. The hematology examination interpreted the blood analysis results to indicate that the dog had normochromic microcytic anemia. A decrease in RBC, hemoglobin, and hematocrit indicates anemia. A low MCV indicates Microcytic, and normochromic is due to a normal MCHC. Treatment is carried out by administering ivermectin, diphenhydramine HCl, and longamox.

Comparative analysis and predictive modeling of hematologic β-thalassemia minor in Pakistan: a cross-sectional study from 2019-2021

Background: Hypo chromic microcytic anemia happens to be the commonest form of anemia in Pakistan. Iron deficiency anemia (IDA) and Beta Thalassemia Trait (BTT) are its most common causes. Both are having similar clinical and laboratory findings. It is necessary to establish relevant cost-effective screening methods based on blood complete picture (CP) to predict BTT in order to reduce burden of Beta Thalassemia Major in Pakistani population.&#x0D; Methods: A cross sectional study was conducted from 2019 to 2021. 10,739 BTT or IDA suspected subjects were recruited. Blood CP was done for each patient to analyze different red cell parameters like total red blood cell count (TRBC), hemoglobin (Hb), mean cell volume (MCV), mean cell hemoglobin(MCH), mean cell hemoglobin concentration(MCHC) and red cell distribution width(RDW). For serum ferritin level, serum was collected after centrifugation and analyzed by using Abbott Alinity chemistry analyzer.&#x0D; Results: 1044 individuals had BTT and 270 were diagnosed as having IDA. Their RBC indices were analyzed using 25 formulae to differentiate between both conditions. Matos and Carvalho index and Pornprasert discriminative index appeared to be the most reliable indices with sensitivity, specificity, positive and negative predictive values, more than 98%.&#x0D; Conclusion: By utilizing Matos and Carvalho index and Pornprasert index, we can cost effectively screen huge population for BTT

SCABIOSIS AND TOXOCARIOSIS IN A LOCAL DOG

A two months old dog, Local Breed male, weighing 1.5 kg with clinical symptoms of crusting on both ears, lichenification on both hind legs and neck, erythema on the alopecia, hair loss almost all over the body, scaly skin (scale), abscesses on both hind legs and enlarged abdomen. The dog looks very dangerous with pruritus 9/10. The purpose of this article is to discuss the management of scabiosis and toxocariosis cases with therapy using sarolaner and pyrantel. On superficial examination of skin scraping, trichogram and skin tape, Sarcoptes scabiei mites were found. On stool examination using the original method, Toxocara canis worm eggs were found. Routine hematological examination results showed that the case dog had hyperchromic microcytic anemia, leukocytosis and lymphocytosis. Based on anamnesis, physical examination and support, the dog case was diagnosed with scabiosis and toxocariosis. Treatment was carried out by administering sarolaner (Simparica®), pyrantel (Drontal®), chlorpheniramine maleate, fish oil, Curcuma (herbafit®), vitamin B complex (Caviplex®), and bathing with antikeratolytic shampoo (sebazole®). On the 30th day after treatment showed improvement with no lesions found on the skin and hair growing properly. In addition, the stomach is not enlarged and the oral mucosa is normal, which is pink. Based on anamnesis, clinical examination, and clinical symptoms, the case dog was diagnosed with scabiosis and toxocariosis with a fausta prognosis. Therapy with sarolaner and pyrantel gives good results. Owners are advised to maintain the cleanliness of the environment where the dog is, and provide food and drink clean food. Giving pyrantel worm medicine to other animals needs to be done so that toxocariosis does not infect other animal cases. Apart from that, other animals need to be given sarolaner medicine so that scabiosis is no longer contagious. In addition, owners are advised to always wash their hands after contact with other animals so as not to transmit the disease to animal cases and are advised not to release animals again.

DIAGNOSTIC ACCURACY OF MENTZER INDEX AS A SCREENING TOOL FOR THE DIAGNOSIS OF IRON DEFICIENCY ANEMIA BY TAKING IRON PROFILE AS GOLD STANDARD IN PATIENTS PRESENTING WITH HYPOCHROMIC MICROCYTIC ANEMIA AT TERTIARY CARE HOSPITAL, KARACHI

Anemia is the most prevalent haematological condition in newborns and children. A deficiency of iron necessary for synthesizing haemoglobin causes it. This study used the iron profile as the gold standard for patients with hypochromic microcytic anemia at a tertiary care hospital in Karachi to assess the Mentzer index's diagnostic accuracy for iron-deficient anemia. From January 2021 to December 2022, a cross-sectional descriptive study was conducted in the Department of Pediatrics, NICH, Karachi. With the patient's explicit consent, data was prospectively collected. Those who satisfied the diagnostic requirements totaled 163 patients. While frequency and percentages were used to represent qualitative factors, simple descriptive statistics with mean and standard deviation were used to convey quantitative data. The following metrics were calculated: diagnostic accuracy, sensitivity, specificity, positive and negative predictive values, and a significance level set at p-value ≤0.05. A total of 163 patients with hypochromic microcytic anemia were included in the study; their mean age was 8.23±3.57 years. 78 (47.9 percent) and 85 (52.1 percent) were female. For the diagnosis of iron deficiency anemia, the Mentzer index's sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined to be, respectively, 90.1 percent, 90.1 percent, 93.8 percent, 84.6 percent, and 90.8 percent. According to the study's findings, cell-count-based indices—in particular, the Mentzer index—are trustworthy, widely accessible techniques that have a high degree of discrimination power for identifying iron deficiency anemia.