Normocytic Normochromic Anemia Research Articles

Detection of Theileria equi‎ in Baghdad Racing Horses Using ‎Hematological and ‎Molecular Assay


 
 
 
 The aim of this study was to investigate the prevalence of Theileria equi‎ infection in racing ‎horses in ‎‎Baghdad governorate, utilizing clinical signs, microscopic examination, molecular ‎assays, and ‎hematological ‎tests to identify significant differences between infected and non-‎infected horses. Between ‎January and ‎December 2021, a total of 160 racing horses from three ‎locations in Baghdad governorate (Al-‎Amiriya ‎Equestrian Club, Arabian horses in Alzwraa ‎Zoo, and Iraqi Equestrian School) were randomly ‎selected for ‎examination. Microscopic ‎examination of blood smears revealed 11 positive samples for ‎Theileria equi‎ ‎‎(6.875%), while ‎the results of the polymerase chain reaction assay targeting the 18S ‎ribosomal RNA gene ‎‎confirmed 26 positives (16.25%). Sequenced amplicons and phylogenetic tree analysis ‎‎revealed a genetic ‎similarity of 93.03–‎100% and 94-100% site coverage compared to many ‎global ‎countries' isolates. ‎Interestingly, only 16 (61.5%) of the 26 infected horses showed ‎mild to subclinical ‎symptoms or were ‎carriers of the disease without tick infestation. ‎Hematological blood parameters ‎showed non-significant ‎differences between infected and ‎non-infected horses, except for a decrease in ‎packed cell volume (PCV) ‎and hemoglobin (Hb) ‎concentration, which caused anemia in 12 horses among ‎the 26 molecularly positive ‎cases ‎‎(46.15%). Of these cases, 6 horses (23.08%) had normocytic ‎normochromic anemia, while 3 ‎‎(11.54%) ‎cases each had normocytic hypochromic and microcytic ‎hypochromic anemia. ‎Notably, young horses (two ‎years old) were more susceptible to infection (odds ratio ‎‎15.4) ‎than those over six years old. Additionally, ‎sex and breed did not show any significant ‎correlation ‎with equine theileriosis. In conclusion, this study ‎detected Theileria equi‎ infection ‎in young racing horses in ‎Baghdad. Clinically, most infected cases showed ‎mild to ‎asymptomatic signs accompanied by anemia. ‎Molecular investigation revealed high genetic ‎‎similarity to isolates reported globally. These findings ‎highlight the importance of ‎implementing measures ‎to control and prevent the spread of Theileria equi‎ in ‎racing horses in ‎Baghdad and other regions. Further ‎studies are warranted to better understand the ‎‎epidemiology, pathogenesis, and risk factors associated ‎with equine theileriosis‎.
 
 
 

Polymyalgia Rheumatica Evolved into RS3PE Syndrome. What is the Culprit: Idiopathic or Secondary, Following mRNA-Based COVID-19 Vaccines? A Case Report and Brief Review of the Literature

We describe the clinical case of a 74-year-old male patient who received the second Comirnaty/Pfizer anti-COVID-19 vaccine dose. After 3 weeks he showed the clinical signs of polymyalgia rheumatica. The history included mild chronic normocytic normochromic anemia and hypogammaglobulinemia, osteoarthritis disease, livedo reticularis, hypercholesterolemia, and arterial hypertension. Despite prolonged treatment with NSAIDs and dexamethasone, the disease evolved into remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Neoplastic diseases and associated collagen diseases were excluded. The clinical picture recurred, soon after, the booster dose of the Spikevax/Moderna vaccine. The inflammatory indices were high, the radiographs of the hands were free of erosions, the ultrasound investigations revealed bursitis of the shoulders, knee synovitis, marked subcutaneous edema of the lower limbs, hydrocele, bilateral Baker's cyst in the popliteal cavity, hematoma of a calf. The clinical picture, markedly improved, with oral prednisolone and was stabilized with the association of hydroxychloroquine. The finding of persistent hypomagnesemia was related to chronic intake of esomeprazole. The reports of rheumatological reactions in international databases and the rare cases of RS3PE <u>s</u>yndrome following the COVID-19 vaccine described in the literature are considered.

Challenges in Diagnosing Infective Endocarditis: A Case Report

Introduction: Infective endocarditis (IE) is an infection that affects the endocardial surface of the heart. Enforcing the diagnosis of IE is quite easy, but in some cases, it is sometimes very difficult to suspect the patient is experiencing an IE if the symptoms displayed are atypical or non-specific, so that the diagnosis and treatment are too late Case illustrations: A 51-year-old man was first referred from a Type C Hospital to the Emergency Room of Type B Hospital with diagnosis of congestive hepatopathy, transaminitis, hyperkalemia, hyponatremia related retention, suspected hypoalbuminemia due to chronic inflammation and hepatopathy, mild normochromic normocytic anemia due to chronic disease, pneumonia, sepsis, AKI (acute kidney injury) with differential diagnose ACKD (acute on chronic kidney disease) because suspect of prerenal suspicion that had been improving. Infective Endocarditis (IE) was diagnosed with modified Duke criteria, in which this patient found vegetation on the aortic valve 1.70 cmx0.66 cm. Treatment for patients was given empirical antibiotics (ampicillin 3 grams every 6 hours by intravenous/IV and gentamicin 180 mg every 24 hours by intravenous/IV) while waiting for blood culture results and the patient was referred to the Central General Hospital/Type A Hospital for further treatment. Conclusion: Infective Endocarditis is still a challenge in the field of medicine with its low incidence. In this case report, the patient experienced a clinical spectrum that was less specific for IE, causing difficulties in early diagnosis and management Keywords: Infective Endocarditis, Modified Duke Criteria, Aortic valve

Feto-Maternal Outcome of Moderate Anaemia in Term Pregnancy at DMCH

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion & 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 & had folic acid ..

Pattern of Suicidal Deaths in Cases Coming to a Tertiary Center in Bangladesh

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion & 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 & had folic acid def

Clinico-pathological correlation study in chronic kidney disease patients undergoing hemodialysis

Chronic Kidney Disease (CKD) is a global health problem and associated with increased morbidity and mortality. Hemodialysis is the most common mode of renal replacement in end stage kidney disease. Variation in hematological and biochemical parameters are the prime factors responsible for morbidity and mortality in CKD patients. Normocytic Normochromic Anemia is a typical morphology seen in CKD patients resulting due to erythropoietin deficiency. Early detection and treatment of these pathologies can improve the quality of life in CKD patients.: 1) To evaluate the clinical manifestations and various pathological changes associated with CKD patients on hemodialysis. 2) To compare and correlate various clinico-pathological parameters in CKD patients on hemodialysis, with special emphasis on diabetic kidney disease.: One year eleven months retrospective study was done at CIMS hospital, which included 50 CKD patients. Complete clinical data were recorded and correlated with various hematological and biochemical parameters. Statistical analysis was performed by chi square test and student’s T test. Out of 50 CKD patients, 86% were male, age group of 41-50 years (62%). The commonest co-morbidity was combined hypertension with diabetes in 44%. Majority (72%) had BP between 140-159mmHg. Most (64%) of the CKD patients were known cases of diabetes. Significantly lower levels of RBC count, hemoglobin, hematocrit and platelet count were found with normocytic normochromic anemia being the commonest morphological type. Significantly increased WBC counts, ESR, serum urea, creatinine and serum phosphate levels were noted in CKD patients. DKD patients showed significant risk compared to NDKD patients. CKD is a progressive, irreversible disease. We found alterations in various haematological and biochemical parameters, which were more severe among DKD patients compared to NDKD patients. Early recognition and management of these changes will have an important impact in improving the quality of life.

The Hyper-Reactive Malarial Splenomegaly- A Rare and Severe Form of Chronic Plasmodial Infection: About A Case

Introduction: Hyper-reactive malarial splenomegaly is a leading cause of large tropical splenomegaly in endemic zones. Here, we report a case diagnosed in a young woman living in Guinea, a malaria-endemic area. Clinical observation: A 32-year-old Guinean woman with a history of repetitive malaria infection episodes presented to the internal medicine outpatient clinic with 5-months history of voluminous mass of the left flank extending to the umbilical region, with no pain and progressive onset, and a sensation of early satiety accompanied by eructation and epigastralgia worsened with eating. Digestive examination revealed a large, firm, smooth-surfaced, painless splenomegaly with a splenic size 20 centimeters below the left costal margin on the mid-clavicular line and measuring 28 centimeters in its long axis. The initial complete blood count showed a normocytic normochromic anemia with lymphocytosis, neutropenia and thrombocytopenia. The erythrocyte sedimentation rate (ESR) was 65 mm at the first hour. Malaria rapid diagnostic test (RDT) was positive for Plasmodium. The thick blood smear had come back negative. Serum protein electrophoresis demonstrated a decrease in albumin to 36.5 g/l and an increase in gamma globulins to 19.1 g/l. Immunoelectrophoresis of serum proteins showed a polyclonal increase in IgG. Abdominal ultrasound revealed enormous homogeneous splenomegaly (180 millimeters). The diagnosis of Hyper-reactive malarial splenomegaly was made on the basis of diagnostic criteria established by Fakunle et al in 1981. Our patient presented with enlarged splenomegaly, negative thick smear, positive RDT for plasmodium, elevated erythrocyte sedimentation rate, lymphocytosis, pancytopenia, and a good therapeutic response. Atovaquone-proguanil 250mg/100 mg at a dose of 1000mg/400 mg, i.e. 4 tablets taken as a single dose over three days, was initiated, then relayed by alternance of doxycycline 100 mg (100 mg once daily) for 1 month and nivaquine 100 mg ..........

HEMATOLOGICAL AND THYROID DISTURBANCE IN AN ALGERIAN POPULATION OF CHRONIC HEMODIALYSIS PATIENTS

Objective: Hemodialysis patients suffer in the majority of cases from normocytic normochromic anemia, due to the decrease of erythropoietin production. Thyroid abnormalities are also observed in these patients. They are represented by hypothyroidism which is characterized by low levels of FT3, normal levels of free thyroxine, and often high levels of TSH The objective is to estimate the prevalence of hypothyroidism and anemia in an Algerian population with end-stage chronic renal failure on hemodialysis. Design and method: This is a descriptive cross-sectional study carried out in the Biochemistry laboratory in collaboration with the Hematology laboratory of CPMC. 94 patients with end-stage chronic renal failure . Results and discussion Results: The mean age of our hemodialysis patients was 59.62 years, with a sex ratio of 0.69. Most of our patients (47%) had arterial hypertension (AH) and 20% of patients had diabetes. Our results show a prevalence of normocytic normochromic anemia in 88.30% of hemodialysis patients. The TSH and FT3 hormone assays in our patients revealed a prevalence of hypothyroidism of 38%, with a female predominance. FT3 was low in 24 patients, 12 patients had high TSH levels. The hypothyroid profile was characterized by normal TSH levels associated with low FT3 levels (25% of patients), 12 patients had high TSH levels associated with normal FT3 concentrations. Thyroid abnormalities in chronic hemodialysis patients (CDH) are secondary to hormonal disorders. They are often represented by hypothyroidism. (Captein, 1996). The results of the comparison of the distribution of hypothyroid and anemic patients show an independence of the distribution of the number of cases according to the symptoms of hypothyroidism. Conclusions: The similarity of symptoms between anemic and hypothyroid hemodialysis patients can mislead the clinician if he does not think to measure thyroid hormones, knowing that the therapeutic conduct is different in the two situations, and the impact on the health economy is very important.

Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes.

Tuberculosis is still endemic in Tunisia. Among musculoskeletal involvement, spinal tuberculosis (STB) or «Pott's Disease» is the most common and can lead to serious neurological complications. The purpose of our study was to focus on STB features (clinical, biological, and radiological) and to identify factors associated with early unfavorable outcomes. This was a monocentric retrospective study, over a period of 20 years (2000-2020). Only patients treated appropriately were included. Patients' informations were noted. We defined the favorable outcome criterion as weight gain, apyrexia, improvement of the general state, relief of pain, improvement in the classic inflammatory markers (CRP), and absence of vertebral deformities, neurological impairment, or sepsis. The outcome was considered unfavorable otherwise. Our study involved 52 patients. Their average age was 55.21 years±17.79. The average symptom duration was 8.9 months±6.54. Spinal pain was the most common functional sign (90.4%) often inflammatory. Physical signs were dominated by segmental spinal stiffness (71.2%). Spinal magnetic resonance imaging was performed in 38 patients. The disco-vertebral biopsy puncture confirmed the diagnosis in 15 cases. All patients received anti-tuberculosis treatments with an average duration of 10.02±1.97months. The outcome at one month of follow-up was favorable in 32 cases. Poor prognosis factors were normochromic normocytic anaemia (p=0.018), initial lymphocytosis (p=0.048), and fever (p=0.01). However, vertebral fracture at standard X-ray was predictive of favorable outcome (p=0.001). STB is a frequent condition that needs to be treated rapidly. Poor prognosis factors were identified in this study such as normocytic normochromic anemia, initial lymphocytosis, and fever at baseline.

Ancylostomiasis in cats in Yogyakarta, Indonesia, and its causative genetic relations

Abstract. Dami JC, Damayanti LPE, Indarjulianto S, Priyowidodo D. 2023. Ancylostomiasis in cats in Yogyakarta, Indonesia, and its causative genetic relations. Biodiversitas 24: 2605-2611. Ancylostomiasis is a zoonotic cat disease caused by one or more species of Ancylostoma spp. This study aims to determine ancylostomiasis in cats in Yogyakarta and its causative genetic relations. This research used ten cats with ancylostomiasis, based on the findings of Ancylostoma spp. eggs in their feces. Cats were examined clinically and laboratory, including blood profile and identification of Ancylostoma spp. eggs. The ITS1-5.8S-ITS2 region of Ancylostoma spp. was amplified by polymerase chain reaction (PCR) and sequenced; the results were compared with the Basic Local Alignment Search Tool (BLAST). As a result, physical examination showed that cats with ancylostomiasis suffered from diarrhea (100%), decreased appetite (70%), weakness (60%), anemia (60%), emaciation, and dull hair (10%). Blood examination showed that 5 (50%) cats had normochromic normocytic anemia, and 1 (10%) cat had hypochromic microcytic anemia. PCR tests, sequencing, and phylogenetic tests found that Ancylostoma spp. isolates had been successfully identified as Ancylostoma braziliense De Faria 1910, identical to A. braziliense from Australian isolate (DQ359149.1). Therefore, it was concluded that ancylostomiasis in cats in Yogyakarta was caused by A. braziliense.

P437 HEART AND RHEUMATOLOGICAL DISEASE: A PICTURE OF ACUTE HEART FAILURE

Abstract Systemic sclerosis is a connective tissue disease characterized by endothelial dysfunction, hyper reactivity of fibroblasts and immunity abnormality in both humoral and mediated cells. Clinically, in addition to the typical skin involvement, mainly the face and fingers, is frequent involvement of lungs, heart and kidneys. Cardiac involvement, in combination with lung involvement, is considered to be the most important determinant of the prognosis of these patients. Cardiac involvement occurs in 15– 35% of cases but in autopsy surveys the incidence reaches 80%. The case we present concerns a woman of 65 years, admitted in December at the Department of Cardiology of our AOU for an episode of low–output heart failure with epigastralgia, sweating, and breathlessness. The cardiological history was almost silent; instead, it presented a history of chronic thyroiditis and a recent infection with SARS COV 2. The objective examination presented hypokinesis of basal pulmonary fields and pitting edema. The blood tests showed an increase in myocardial necrosis, BNP, creatininemia and inflammatory indices (VES, PCR, beta 2 microglobulin, ferritin, fibrinogen), normocytic normochromic anemia, hypogammaglobulinemia, hyperuricemia and proteinuria and hematuria. The echocardiogram showed severe biventricular dysfunction and moderate–grade mitral insufficiency. A coronary examination was performed that showed epicardial coronary vessels free from significant injury. The cardiac magnetic resonance showed a widespread late enhancement subendocardial of the ventricular and atrial chambers with non–vascular distribution suggestive of pathology on an autoimmune basis. Upon closer examination, multiple small telangiectasias were observed in the face, slight hyperpigmentation of the chest and back, and swelling of the hands. The antibody panel showed positivity of ANA and anti Scl70. The patient was thus addressed to a multi–specialist management in which therefore cardiologist and rheumatologist compare and support the treatment of this pathology with the goal of reducing the high mortality and morbidity that characterizes systemic scleroderma with cardiac involvement.

Idiopathic pure red cell aplasia: A case series from India

Pure red cell aplasia (PRCA) is a rare hematologic disorder characterized by normocytic normochromic anemia with reticulocytopenia and depleted erythroid precursors. It is reported mainly from western countries. We report our experience in two patients of PRCA from India, the clinical characteristics, differential diagnosis, and their management. Our patients showed improvements following treatment with corticosteroids, blood transfusion, and/or rituximab.

Plasma cell leukemia: A rare case

Plasma cell leukaemia is an extremely rare haematological malignancy with a poor prognosis. It is defined by the presence in the circulating blood of a number of plasma cells greater than 2 giga/L or greater than 20% of the leukocytes. It presents in two forms: secondary plasma cell leukaemia complicating a known multiple myeloma, and primary plasma cell leukaemia, which is leukaemic in origin. We report the observation of a 52-year-old Moroccan patient who presented with bone pain and general deterioration 3 months before hospitalisation. The haemogram revealed normocytic normochromic anaemia at 8.1 g/dL and hyperleukocytosis. The blood smear showed the presence of 38% of plasma cells. The myelogram confirmed the diagnosis of APL by showing a rich marrow with 63% dystrophic plasma cells. In this case, we emphasise the importance of careful cytological examination of the blood smear.

STUDY OF URIC ACID LEVELS IN PATIENTS WITH HYPOTHYROIDISM AND ITS CORRELATION WITH SERUM THYROID STIMULATION HORMONE LEVELS

Aim: we aimed to investigate whether there is a correlation between uric acid levels and TSH levels in the patients with hypothyroidism. This observational cross-sectional study was Material and method: conducted on patients attending OPD/ IPD of Hospitals afliated to Bangalore Medical College and Research Institute, Bangalore from November 2019 to May 2021. Data of all the patients satisfying the inclusion and exclusion criteria was collected. Data was analyzed by descriptive statistics. Pearson correlational analysis/Spearman's rank correlation was used to assess the correlation between Uric acid and TSH levels. A total of 90 cases were taken up Results: for the study. The mean age of the subjects was found to be 32±8 years, 82(91%) were females and only 8(9%) were males. The average height of the subjects was 158.67±9.31 cm. The average weight was 63.94±9.72 kg. The mean pulse rate of the subjects was 75.62±5.66, mean RR was 18.63±1.83, mean BP was 111±7/75±5. The average T3 was observed to be 1.59±0.96, average T4 was 3.83±3.73 and average TSH was 30.89±20.93. The mean serum uric acid of the subjects was 6.3±1.28 mg/dl, mean serum creatinine was 0.87±0.15 mg/dl and mean eGFR was 85.44±16.45, mean HB was 11.58±1.69, MCV was 79.81±6.76. Platate count was 2.92±1.35. The average Ferritin was found to be 185.21±359.03. The average LDH was 296.46±106.35, microcytic hypochromic anemia was present in 21(23%) subjects and normocytic normochromic anemia was present in 69(77%) subjects. Pearson correlation analysis showed that there was positive association between TSH and serum uric acid, among the subjects. However, the association was not found to be statistically signicant as p>0.05. Although not statistically Conclusion: signicant, a positive correlation was observed between the uric acid and thyroid stimulating hormone.

Prevalence and types of anemia among people with tuberculosis in Africa: a systematic review and meta-analysis

Globally, tuberculosis (TB) and anemia are public health problems related with high morbidity and mortality. Furthermore, anemia is frequently manifested among people with TB in Africa, prevalence ranging from 25 to 99%. The presence of anemia is associated with an increase in individuals’ susceptibility to TB and poor treatment outcomes. Studies have reported heterogeneous estimate of prevalence of anemia among people with TB in Africa. This review aimed to estimate the prevalence of anemia among newly diagnosed people with TB n Africa. We searched studies in Medline/PubMed, Cochrane library, ScienceDirect, JBI database, the Web of Science, Google Scholar, WorldCat, Open Grey, Scopus, Agency for Healthcare Research and Quality, ProQuest, and African Journals Online that reported the prevalence of anemia at TB diagnosis. Two reviewers performed data extraction with pre-defined inclusion criteria. A random-effects logistic regression model was used to pool the prevalence of anemia and levels of anemia with a 95% confidence interval (CI) in STATA version 14. Heterogeneity and publication biases were explored. A total of 1408 studies were initially identified, and seventeen studies with 4555 people with TB were included in the analysis. The prevalence of anemia among people with TB in Africa was 69% (95% CI 60.57–77.51). The pooled prevalence of anemia of chronic disease was 48% (95% CI 13.31–82.75) and normocytic normochromic anemia was 32% (95% CI 13.74–50.94) while mild anemia was 34% (95% CI 20.44–46.86). Females were more anemic than males at TB diagnosis in Africa (74% vs. 66%). The finding indicates that anemia is a common co-morbidity present among people with TB, especially among females. Mild anemia and normocytic normochromic anemia were more common at TB diagnosis. The finding indicates that anemia is a common co-morbidity present among people with TB in Africa region. Hence, it is recommended to instigate a routine anemia screening at TB diagnosis to improve treatment outcomes.

COMPARATIVE STUDY OF AUTOMATED CELL COUNTER HISTOGRAM AND PERIPHERAL BLOOD SMEAR IN DIAGNOSIS OF ANAEMIA AT TERTIARY CARE HOSPITAL

Introduction: In recent years, complete blood count, red blood cell histogram and peripheral blood smear have become important diagnostic tools for diagnosing various blood diseases. Anemia is a major public health problem worldwide, with high prevalence in developing countries like India1. Red blood cell count and histograms are essential for the diagnosis and management of anemia2. The most important diagnostic tool for testing in most commercial laboratories is the periodic analysis of blood lms. AIM: the aim of this study was to compare the role of automated cell count histograms and peripheral blood smear results in the diagnosis of anemia.. Material and method:A prospective comparative study of RBC histogram and peripheral blood smear in diagnosis of anemia was done on 900 patients of HB<14gm%, over two month time span(September 2022-October 2022) in the central laboratory lab, Department of pathology, Gajra Raja Medical College, Gwalior, Madhya Pradesh. All cases of anemia who received blood transfusions were excluded from this study. Result:It was observed in our study that on peripheral blood smears, the most common type of anemia was microcytic hypochromic anemia, followed by normochromic normocytic anemias. When we compared with the histogram generated by the automated cell counter, the most common type of anemia was hypochromic microcytic anemia, followed by normochromic normocytic anemia. In our study, the female population was more numerous than the males. The average age is (23 years old). Conclusion:CBC histograms and peripheral blood smears generated by automated cell counters play an important role in the diagnosis and management of red blood cell disorders. Our study observed that the histogram pattern and its conrmation by the peripheral blood smear along with the clinical medical history allow an accurate and conrmed diagnosis of various blood disorders. Accuracy and precision have been greatly improved resulting in reducing the subjective error3 .

CORRELATION OF PERIPHERAL SMEAR WITH RBC INDICES AND RBC HISTOGRAM IN THE DIAGNOSIS OF ANAEMIA IN TERTIARY CARE CENTRE

Introduction : Anaemia is a decrease in the oxygen-carrying capacity of the blood. RBC histogram is a standard part and is routinely generated by automated cell analyzers. The well-known Coulter principle of counting and sizing the cells provides a basis for generating a histogram. The peripheral blood smear has been the main diagnostic aid in establishing the etiology of anaemia. Examining the blood lms routinely has facilitated the interpretation of various haematological disorders. Materials and Methods: The present study was carried out in the haematology laboratory of Kamineni Institute of Medical Sciences, Narketpally over a period of 3 months. EDTA blood samples from 100 anaemic patients were run in a six-part Sysmex analyzer and peripheral smears were prepared and examined. Results: A total of 100 patients with peripheral blood smear and RBC histogram from automated analyzer were studied. Out of 100 patients, 60% were females and 40% were males. Normocytic normochromic anaemia (50%) was the most commonly observed anaemia in the present study followed by microcytic hypochromic anaemia (40%). Most common histogram pattern observed was normal bellshaped curve. In normocytic normochromic anaemia (50%), the majority of the cases show a normal bell-shaped curve (37%) and the remaining 13% of cases showed broad-based curve. In microcytic hypochromic anaemia (40%) most common histogram pattern observed was shift to the left. In dimorphic anaemia (8%) histogram pattern observed was bimodal peak with a broad base. In macrocytic anaemia (2%) most commonly seen histogram pattern was shift to the right. Conclusion: Histogram plays an additional role with peripheral smear for diagnosing RBCs disorders. Even in the age of molecular analysis, the blood smear examination remains an important diagnostic tool.

Parvo B19 and Anaemia: The Various Profiles – A Mini Review

Introduction: Parvovirus 19 (Parvo B19) is a single stranded DNA virus which predominantly affects school-aged children, parents of such children and adults who are working in day care centres or schools. Individuals with underlying haemoglobinopathies, haemophilia, immunocompromised, malignancy and pregnancy states are at a higher risk of infection. This virus has been associated with multiple clinical manifestations including erythema infectiosum, arthopathy, fetal cardiomyopathy and hydrops fetalis. However, one of the most significant complications is the anaemia caused in the adult population. This includes pure red cell aplasia and transient aplastic crisis (TAC). Review: Pure red cell aplasia occurs predominantly in patients with immunocompromised states. The aplasia characteristically presents with a chronic or recurrent severe normocytic normochromic anaemia with reticulocytopaenia. The bone marrow reveals an absence of red-cell precursors or with the presence of giant pro-normoblasts with intra-nuclear inclusions. The condition is effectively managed using packed red cell transfusions, based on the degree of anaemia, and with intravenous immunoglobulin at 1g/kg over a period of 2 days or, more preferably, 500mg/kg over 5 days. The majority of patients respond after 1-3 doses. Correction of the underlying patient risk factors is vital. TAC occurs more frequently in patients with underlying red-cell abnormalities. This presents with a one to two week severe anaemia with variable smear and cellular findings varying from microcytic hypochromic to normocytic normochromic. Additionally, there is a reduced reticulocyte percentage and index. Packed red cell transfusion and correction of the underlying risk factor are often sufficient for the management of anaemia. The addition of immunoglobulin administration, 500mg/kg over 5 days, may be needed for patients who are immunocompromised. Conclusion: Parvovirus B19 remains a prevalent and prominent virus associated with multiple medical conditions particularly in immunocompromised states such as that of HIV, as well as erythrocyte disorders. Clinically, the virus has a plethora of presentations, two of which are severe anaemias: transient aplastic crisis and pure red cell aplasia. These conditions may be effectively and successfully managed with intravenous packed red-cell transfusions, intravenous immunoglobulins and by addressing of the underlying patient risk factors.

Analysis of Mean Corpuscular Volume and Red Cell Distribution Width in Patients with Aplastic Anemia

To explore the characteristics of hemogram in patients with aplastic anemia (AA), especially mean corpuscular volume (MCV) and red cell distribution width (RDW). We examined the blood routine of 180 new-onset AA patients and used 166 patients with myelodysplastic syndrome (MDS) as controls. Among the 180 AA patients, 105 (58.3%) were diagnosed with severe AA (SAA), while 75 (41.7%) were diagnosed with non-severe AA (NSAA). Compared to MDS, patients with SAA generally had unfavorable hemogram, including significantly lower white blood cell (WBC), absolute neutrophil count (ANC), hemoglobin (Hb), platelet (PLT) and reticulocyte counts (RET). However, WBC, ANC and lymphocyte counts were higher in the NSAA group than in the MDS group; Hb and Ret were comparable between the two groups. 8.5% of SAA patients and 58.1% of NSAA patients presented with macrocytic anemia, whereas 25.7% of SAA and 64.0% of NSAA had a high RDW. In the MDS group, 54.7% of patients presented with macrocytic anemia, and 84.7% had increased RDW. WBC, ANC, PLT, and Ret in a high-RDW group (25.7% of SAA) were significantly higher than in a normal-RDW group (74.3% of SAA). Overall, most SAA patients exhibited normocytic–normochromic anemia, and their hemograms decreased more significantly; more than half of NSAA patients showed macrocytic-heterogeneous anemia, and their hemograms were similar to those of MDS. Patients with elevated RDW may have better residual bone marrow hematopoietic function than those with normal RDW but with more severe anemia.

COMPARATIVE STUDY OF AUTOMATED CELL COUNTER HISTOGRAM AND PERIPHERAL BLOOD SMEAR IN DIAGNOSIS OF ANEMIA

Introduction: Over the past few years, complete blood count, RBC histogram and peripheral blood smear have become the important diagnostic tools to diagnose various haematological conditions. Major public health burden worldwide is anemia with high prevalence in developing countries like India1. Red blood cell and histogram are indispensable for diagnosis and management of anemia2. The major diagnostic tool for work up of most commercial laboratories has been analysing the blood lm routinely. The aim AIM: of the study is to compare between automated cell counter histogram and peripheral smear nding in diagnosis of anemia. Material and method: A prospective comparative study of RBC histogram and peripheral blood smear in diagnosis of anemia was done on 100 patients of HB<14gm%, over six month time span (June2022-Nov2022) in the central laboratory of Saraswathi Institute of Medical Sciences Hapur, (UP) India. This study included all the age groups. All cases of anemia that have undergone blood transfusion is excluded from this study. In Result: our study it was observed that on peripheral blood smear, the most common type of anemia was microcytic hypochromic anemia followed by normocytic normochromic anemia, when we compared with automated cell counter generated histogram most common type of anemia was normocytic normochromic followed by microcytic hypochromic anemia. In our study female population were more than males. The mean age was(32.4yr). Automated cell counters generated CBC histograms and peripheral blood smears Conclusion: plays a major role in diagnosis and management of red cell disorder. Our study observed that histogram patterns and their conrmation by peripheral blood smear along with clinical history gives accurate and conrmed diagnosis of various haematogical conditions. There is much improvement in accuracy and precision 3 reducing the subjective errors .