Percentage Of Hb Research Articles

Hematoprotective Effect of Eugenol against Iron Overload in Male Rats

This study aimed to evaluate the hematoprotective effects of eugenol against iron overload in male rats. A total of 30 rats were randomly divided into six equal groups as follows: the control negative (C-) group I.P injection distal water. The control positive (C+) group received iron dextran (100 mg/kg-BW) I.P injection. The IE1 and IE2 groups received iron dextran 100 mg/kg-BW I.P and eugenol (50,100 mg/kg-BW) orally, respectively, and the E3 and E4 groups received eugenol (50,100 mg/kg-BW) orally. After 30 days of the experiment, the blood was collected to measure the experimental parameters. The results demonstrated a significant increase in RBCs, Hb percentage, WBCs, PCV, and PTL in the C+ group compared to the C- group. Also, there was a non-significant difference between IE1 and C+ in RBCs and Hb. Meanwhile, PCV decreased significantly in IE1 compared with C+. Conversely, the C+ group showed decreased MCV compared with IE1. Microscopic examination of blood smears indicated normal red blood cell morphology in the C- and iron dextran with eugenol-treated groups, while the C+ group exhibited microcytic hypochromic morphology. In conclusion, the ameliorative effect of eugenol against iron overload-induced hematotoxicity is achieved by restoring the hematological parameters near the normal control.

Influence of hydroxyurea on tubular phosphate handling in sickle cell nephropathy

ObjectiveThis study aims to evaluate the markers of tubular phosphate handling in adults with sickle cell anemia (SCA) and the influence of hydroxyurea (HU), the degree of anemia and Hb F concentration on these markers. MethodsEighty-eight steady state SCA patients in outpatient follow-up in Fortaleza, Ceara, Brazil and 31 healthy individuals were included in this study. Vitamin D (25OHD) was measured by enzyme-bound fluorescence assay, intact parathyroid hormone (iPTH) by electrochemiluminescence, and serum and urinary phosphate and creatinine by colorimetric methods. Details of Hb F and HU use were obtained from clinical records. Tubular reabsorption of phosphate (TRP) and maximum tubular reabsorption of phosphate (MTRP) were calculated. SCA patients were stratified according to the use of HU, degree of anemia and percentage of Hb F. The significance level was set for p-values <0.05. ResultsCompared to controls the 25OHD level (25 ± 11 vs. 30 ± 9 pg/mL) was lower in SCA, while serum phosphate and MTRP were higher (3.86 ± 0.94 vs. 3.46 ± 0.72 and 3.6 ± 1.21 vs. 3.21 ± 0.53, respectively). There was no significant difference in iPTH, TRP and phosphaturia. Serum phosphate showed correlation with TRP (r = 0.32; p-value = 0.008) and MTRP (r = 0.9; p-value <0.001) in SCA. Patients taking HU, especially those with Hb F >10 % presented reduced serum phosphate levels, and TRP and MTRP rates. Those with mild anemia presented reduced serum phosphate levels and MTRP rates. ConclusionSerum phosphate levels and renal phosphate reabsorption rate were increased in SCA. HU use, high Hb F concentration and total Hb were associated with better control of tubular phosphate handling markers.

Assessment of creatinine and blood urea in kidney failure patient within Kerkuk city, Iraq

The assessment of creatinine, a waste product produced by muscle metabolism that is filtered out of the body by the kidneys and the levels of blood urea are important tools for monitoring kidney's function. A total of 191 patients (105 male and 86 female) encountered in this study, with kidney failure compared with 21 control healthy individuals (11 male and 10 female). A significant increase (p≤0.0012) in creatinine was detected in kidney failure patients (9.3±3.2) in comparison with control (0.62±0.1) as well as between the genders. In female the creatinine level was significantly higher (p≤0.05) than that of male. The general levels of urea have also elevated in kidney failure disease (KFD) from (112±42) in comparison with control (25±10) but with a slight significant difference (p≤0.05) between the genders. The percentages of Hb% showed a significant decrease (p≤0.007) in kidney failure patients in comparison with control of all cases. Similarly, the packed cell volume (PCV) had significantly dropped down (p≤0.01) in total patients as well as in between genders in comparison with their counter control. Increased urea 4-5 folds in kidney patients confirms, to certain extend, the occurrence of dysfunction of kidneys and failure to re-absorb the nitrogen components leading to elevation of its amount in patients. Regular monitoring of creatinine and blood urea levels, along with other factors deems essential for improving patient health and quality of life.

Assessing Real-Time Sickling Kinetics in Individual Cells from Erythrocyte Populations of Subjects with Different HbA, HbS and HbF Percentages

INTRODUCTION: Polymerization of deoxygenated sickle hemoglobin (HbS) leads to erythrocyte sickling. Treatment in sickle cell disease (SCD) aims to reduce the risks of red blood cell (RBC) sickling and associated complications including, but not limited to vaso-occlusive crises (VOC). There is substantial promise in developing therapies targeting HbS polymerization that consequently decrease RBC sickling, a fundamental pathophysiological driver of SCD. Nonetheless, there are limited options available for reliable diagnostic tools for the assessment of disease status and therapeutic outcomes. A robust and easy-to-use system to assess population-scale sickling kinetics and to monitor responses to Hb-modifying therapies in clinical trials for the clinical management of patients may be beneficial. We have developed a dynamic sickling assay (DSA) that uses an enzymatic oxygen scavenging system to provide tight control over the rate and depth of induced-hypoxia. DSA is able to differentiate samples based on endogenous Hb expression and can be used to monitor sickling kinetics pre- and post HbS-modifying therapies, including hematopoietic stem cell transplantation (HSCT). METHODS: SCD and sickle cell trait (SCT) subjects were recruited under the RBC Health Initiative IRB protocol number FF-RBC-003. Four hematopoietic stem cell transplant (HSCT) SCD subjects were enrolled in NIH haploidentical HSCT protocol 17-H-0069. Diluted blood samples were supplemented with protocatechuic acid (PCA), followed by protocatechuate 3,4-dioxygenase (PCD) enzyme inducing hypoxia at a predetermined rate. The sample was then injected into a microfluidic chamber, and resulting RBC morphological changes were observed and captured with time-lapse photography. Image analysis identified and quantified RBC using an AI-trained SICKLE image analysis software. HbAS (n=3), HbSS with HbA (post-transfusion, n=3) and HbSS samples containing 3.1 to 34.5% HbF (n=9) were processed with DSA to assess the effects of hemoglobin distribution on sickling kinetics.Pre- and post-HSCT samples were run to ascertain the effect on sickling kinetics at baseline, 3M, 6M and 12M post-HSCT. Sickling profiles were constructed enabling a comprehensive assessment of RBC sickling and treatment outcomes. The reported parameters include: mPOS@5% (time to reach 5% induced sickling, min), mPOS@50% (time to reach 50% maximum induced sickling,min), rate of sickling (the maximum sickling rate, %/min), maximum induced sickling (the highest induced sickling percentage, %), AUC at 10min (area under the curve@10min of DSA, %∙minute) RESULTS: DSA inter-run CVs are 6.9% for mPOS@5%, 3.8% for mPOS@50%, 2.7% for max sickling, 4.2% for AUC and 10.8% for the rate of sickling. Statistically significant correlations are observed between %HbS and rate of sickling, max sickling, mPOS@5%, and AUC at 10min. As percentages of Hb increased in transfused SCD patient samples, there were noticeable correlations between the delay in mPOS@5% and decreased rate of sickling, maximum sickling, and AUC10. Similarly, as HbA percentages increased in SCT samples, a decrease in AUC10 and max sickling were observed. Transfused and SCT samples did not show statistical significance due to sample size limitations. However, there was a strong correlation in delay of mPOS@5% and mPOS@50%, as well as a decrease in the rate of sickling and AUC10 with increasing percentages of HbF in samples (Table 1). Comparing pre-HSCT (BL) sample sickling kinetics to 3, 6 and 12 month post-HSCT samples showed decreases in the rate of sickling (from 44.4 to 0.6%), maximum sickling (from 45-23%), decreases in AUC and delays in mPOS (Table 2). CONCLUSIONS: This study found significant linear relationships between %HbS and sickling parameters.As HbA percentage increases in transfused SCD and SCT samples, improvements in sickling parameters are observed. There is a strong correlation between increased HbF percentage and improved DSA parameters. Comparative data analysis from patients pre- and post-HSCT also show improvement in sickling parameters. Overall, DSA provides a simple, robust method for assessing responses to Hb differences and monitoring SCD therapies such as gene-editing.

#3676 EVALUATION OF HAEMOGLOBIN RESPONSE IN PATIENTS WITH CKD-RELATED ANAEMIA NOT ON DIALYSIS RECEIVING DAPRODUSTAT OR CONTROL IN ASCEND-ND

Abstract Background and Aims Daprodustat (Dapro) is a novel hypoxia-inducible factor prolyl hydroxylase inhibitor being investigated in anaemia of chronic kidney disease (CKD). ASCEND-ND1 achieved non-inferiority (NI) for Dapro vs darbepoetin alfa (Darbe) in both coprimary endpoints, mean change in haemoglobin (Hb) levels from baseline to the evaluation period (EP; Week [Wk] 28–Wk 52) and first occurrence of a composite major adverse cardiovascular event, in patients (pts) with anaemia of CKD not on dialysis. Here, we present key Hb efficacy data and evaluate differences in Hb response within ASCEND-ND subgroups. Method Pts with Stages 3–5 CKD (not on erythropoiesis stimulating agents [ESAs]: Hb 8–10g/dL; on ESAs: Hb 8–11g/dL) were randomised 1:1 to Dapro or Darbe. Statistical analysis methods for the coprimary endpoint have been published.1 Secondary endpoints evaluated during the EP included: 1) the percentage of Hb responders (pts with mean evaluable Hb within the analysis range [10–11.5g/dL]); 2) the percentage of time Hb was within the analysis range; 3) analysis of Hb change from baseline to Wk 52. Secondary endpoints were analysed as follows: 1) Cochran-Mantel-Haenszel test adjusted for ESA use and region; 2) Rosendaal method (evaluable Hb values) and Hodges-Lehmann and stratified Mann-Whitney estimates of treatment effect, analysed with a van Elteren's test stratified by ESA use and region; 3) mixed model repeated measures analysis (on-/off-treatment, observed Hb values from Wks 28–52) with factors for ESA use, region, baseline Hb (by time), treatment by time interactions. Secondary and subgroup analyses were not multiplicity adjusted. Results Of 3872 pts in ASCEND-ND (Dapro n = 1937; Darbe n = 1935), mean baseline Hb levels were similar for both treatment arms and mean change in the EP Hb level for Dapro and Darbe met the prespecified NI margin of ‒0.75 g/dL (difference = 0.08g/dL; 95% confidence interval [CI] = 0.03, 0.13).1 Subgroup analyses were consistent with coprimary analyses (Table), with little or no heterogeneity between most groups: 7/22 subgroups (ethnicity, high-level race, region, ESA use at randomisation, prior ESA dose group, history of stroke, and hospitalisation 6 months prior to screening) had interaction p values &amp;lt;0.1; however, all subgroups met the NI criterion with between-group differences that were not clinically meaningful. Proportions of pts within the Hb analysis range were higher for Dapro than Darbe in the EP overall and regardless of baseline ESA use and similar for region (Table). The median (interquartile range) percentage of time Hb was in the analysis range during the EP was 70.5% (45.3%–93.2%) for Dapro vs 63.2% (33.7%–88.9%) for Darbe. Dapro was associated with a nominally NI (margin of ‒15%) and significant increase in percentage time in analysis range during the EP (estimate of median difference [95% CI] = 4.57% [2.04%, 7.11%]; one-sided p&amp;lt;0.0001). The estimate (95% CI) for the probability that Dapro had a greater percentage of time Hb within the analysis range than Darbe was 0.55 (0.53, 0.57); the lower boundary of the 95% CI exceeded 0.50, representing equal probability between the two treatment arms. Results by region were similar for Dapro vs Darbe (treatment effect): Asia Pacific = 0.56; Eastern Europe/South Africa = 0.51; Western Europe/Canada/Australia/New Zealand/Israel, 0.58; Latin America, 0.58; USA, 0.55). In mixed-model repeated measures analysis, g/dL Hb change (standard error) at Wk 52 was 0.76 (0.029) with Dapro and 0.73 (0.029) with Darbe (difference [95% CI] = 0.03 [−0.05, 0.11]). Hb efficacy was similar regardless of ESA use (Figure). Conclusion Dapro was effective and NI to Darbe for maintaining Hb in non-dialysis pts with anaemia of CKD, and results of subgroup analyses were consistent with the coprimary analyses. Additionally, Dapro raised and maintained Hb within the analysis range regardless of baseline ESA use or region. These preliminary analyses indicated a nominal NI showcasing greater Hb time in range with Dapro vs Darbe; further analyses will be presented to fully characterise this interaction.

Opening a Crack in the Door: An Interview with Haydar Frangoul

Opening a Crack in the Door: An Interview with Haydar Frangoul

Model-informed drug development of voxelotor in sickle cell disease: Exposure-response analysis to support dosing and confirm mechanism of action.

Sickle cell disease (SCD) is characterized by the production of sickle hemoglobin (HbS), which when deoxygenated, polymerizes leading to red blood cell damage and hemolytic anemia, a defining feature of SCD. Voxelotor (Oxbryta) is a small molecule inhibitor of HbS polymerization that disrupts the polymerization mechanism by binding HbS to increase HbS oxygen affinity. Voxelotor is approved in the United States for the treatment of SCD in patients greater than or equal to 12 years of age at a 1500 mg once‐daily (q.d.) dose. These exposure‐response analyses aimed to evaluate the relationships between voxelotor whole blood concentration and change from baseline (CFB) in clinical measures of anemia and hemolysis and between voxelotor whole blood and plasma concentrations and the incidence of selected safety end points to confirm the voxelotor mechanism of action and to support the clinical dose recommendation. In patients treated with voxelotor up to 72 weeks, CFB hemoglobin (Hb) increased linearly (p < 0.001) with increasing voxelotor concentration and percent Hb occupancy and increases in CFB Hb corresponded to improvements in measures of hemolysis. The target 1 g/dl increase in CFB Hb was achieved with 1500 mg voxelotor q.d. Significant relationships were observed between voxelotor exposures and grade greater than or equal to 1 increased alanine aminotransferase and decreased white blood cell count; however, most events were grade 1. No clinically important covariate effects on voxelotor efficacy or safety were observed. Overall, these analyses support 1500 mg q.d. as the therapeutic dose for voxelotor in adults and adolescents.

β-Thalassemia Intermedia: Interaction of α-Globin Gene Triplication With β-thalassemia Heterozygous in Spain.

ObjectivesTo verify with hematimetric data that the diagnosis and clinical grade of β-TI can be established when a triplication of alpha genes (αααanti 3.7) and heterozygous β-thalassemia coexist.Materials and MethodsRetrospective study in which 73 patients of Caucasian origin participated, who simultaneously showed a triplication or quadruplication of genes α and β-thalassemia.Screening for the most frequent α-thalassemia mutations as well as gene triplication (αααanti 3.7) was carried out by multiplex PCR followed by reverse hybridization with a commercial Alpha-Globin StripAssay kit and confirmed by MLPA (Multiplex ligation-dependent probe amplification). The molecular diagnosis of β-thalassemia was carried out by automatic sequencing according to the Sanger method.ResultsThe genotypes have been classified into three groups according to the number of α globin genes and the severity of the alteration in the β globin gene. All had a mutation in the HBB gene (β0-thalassemia, β+-thalassemia severe, and β+-thalassemia mild). Group I patients who have coherent 6 α genes and groups II and III with 5 α globin genes. In group III, the patients were carriers of mutations affecting the β and δ globin genes. The most significant hematological parameters were hemoglobin levels, MCV, RDW, and the percentage of Hb F.ConclusionsIn group I, regardless of the distribution of the 6 α globin genes, homozygous triplication (ααα/ααα) or heterozygous quadruplication (αααα/αα), the association with heterozygous β-thalassemia results in severe to moderate anemia that may or may not require transfusion therapy, is the severity of the HBB gene mutation that would determine the clinical variation. Group II patients phenotypically behaved like mild thalassemia intermedia, except for one case that presented thalassemic trait because it also presented an associated α-thalassemia (ααα/-α3.7). Finally, group III patients behaved as a thalassemic trait since all were carriers of mutations that increase the overexpression of γ genes.

Assessment of Hemoglobin Level in the Rural Area with Special Reference to Human Beings

Blood is a Fluid connective tissue in higher animals that transports necessary substances viz., Oxygen, Carbon dioxide, nutrients, Hormones etc. Haemoglobin (Hb) is a globin protein which plays a vital role in the transport of substances. Abnormal level of haemoglobin causes disorders like Anemia, Sickle cell anemia and Viral diseases. The percentage of Hb is differ in different age, sex, ethnic background, body build social, nutritional and environmental factors. Anemia is a condition where there is decrease in the level of Hb the cut –off levels of Hb, which is given by WHO. In this study we analyzed the Hb (g/dl) in the different groups like Male –female etc.

Anti-Diabetic Activity of Bioactive Compound Extracted from Spondias mangifera Fruit: In-Vitro and Molecular Docking Approaches.

Spondias mangifera is a drupaceous fruit popular for its flavour and health advantages. There is little scientific knowledge about S. mangifera, despite its widespread usage in traditional medicine, in the North-Eastern region of India. Inhibiting the key carbohydrate hydrolysing enzymes is one of the strategies for managing diabetes. Therefore, this study studied the antioxidant and anti-diabetic properties of different fraction S. mangifera fruit extract (SMFFs) from Indian geographical origin by in vitro experimental assays and silico docking simulation studies. The ADMET prediction for active substances was also investigated using the AdmetSAR database. Based on the binding affinity/molecular interactions between phytocompounds and target enzymes, in silico investigations were done to confirm the in vitro enzymatic inhibitory capability. β-sitosterol in EtOH-F was analysed using RP-HPLC with RP-C18 column as stationary phase and photo diode array detector. The percentage of β-sitosterol was found to be 1.21% ± 0.17% of total weight of extract (w/w). S. mangifera fruit ethanolic extract had a significant inhibitory concentration of 50% against free radicals produced by ABTS (89.71 ± 2.73%) and lipid peroxidation assay (88.26 ± 2.17%) tests. Similarly, the in vitro antidiabetic test findings indicated that S. mangifera inhibited alpha-amylase (73.42 ± 2.01%) and alpha-glucosidase (79.23 ± 1.98%) enzymes dose-dependently. The maximum glycosylated Hb percentage inhibitory activity shown in the ethanolic fraction was (83.97 ± 2.88%) at 500 µg/mL. The glucose uptake of the ethanolic fraction by the yeast cell showed significant (p < 0.05) at 500 µg/mL when compared with metformin (91.37 ± 1.59%), whereas the other fraction did not show the uptake of glucose by the yeast cell at the same concentration. In the docking study, the main phytoconstituents of S. mangifera fruit, such as oleanolic acid, beta-sitosterol, and beta amyrin, show strong affinity for pancreatic α-amylase. These results imply that S. mangifera has α-amylase and α-glucosidase inhibitory properties and may be used as antidiabetic with antioxidant characteristics.

Newborn Screening Practices for Beta-Thalassemia in the United States.

Beta-thalassemia, a heritable condition of abnormal hemoglobin production, is not a core condition on the United States Recommended Uniform Screening Panel (RUSP) for state and territorial newborn screening (NBS) programs. However, screening for sickle cell disease (which is on the core RUSP) also detects reduced or absent levels of hemoglobin (Hb) A and certain other Hb variants associated with beta-thalassemia and, thus, allows for a timely referral to appropriate healthcare to minimize sequalae of the disease. The Association of Public Health Laboratories’ Hemoglobinopathy Workgroup administered a comprehensive survey of all U.S. NBS programs to assess beta-thalassemia testing methodologies, the cutoffs for defining beta-thalassemia major, and the reporting and follow-up practices. Forty-six (87%) of the programs responded. Thirty-nine of the 46 responding programs (85%) report some form of suspected beta-thalassemia; however, the screening methods, the percentage of Hb A used as a cutoff for an indication of beta-thalassemia major, and the screening follow-up vary widely. The standardization of technical and reporting procedures may improve access to specialty care prior to severe complications, increase genetic counseling, and provide data needed to better understand the public health impact and clinical outcomes of beta-thalassemia in the United States.

A RETROSPECTIVE STUDY ON PREVALANCE OF ANEMIA IN PREGNANCY IN A TERITIARY CARE HOSPITAL

Objective: To study about prevalence in anemia among the antenatal women, its clinical features, and access the severity and its treatment response. Methods: A hospital-based retrospective study on the prevalence of anemia among the antenatal women in tertiary care hospital for 6 months duration in gynecology and obstetrics department. In evaluating pregnant women with anemia, it is essential to do a complete history and physical examination, as well as complete blood count with indices and a blood smear examination. Based on these findings, other test such as ferritin and serum or red cell folate may be ordered. Because of normal physiologic changes in pregnancy that effect the hematocrit, indices, and some other parameters, diagnosing true anemia, as well as the etiology of anemia, is challenging. Results and Discussion: In this retrospective study, the prevalence of Anemia in pregnancy in a tertiary care hospital was evaluated and determined in fifty patients. The most common age group was between 21 and 25 years i.e., (21 patients) 42%. Among 50 patients, majority of them, i.e., 35 patients (70%) were treated with Injection. Iron Sucrose (200 mg). In this study, increase in prevalence were seen majorly in the third trimester, i.e., 25 patients (50%) of which 22 patients (88%) were with moderate anemia with 7.9 gm/dl average hemoglobin (Hb) percentage and 3 patients (12%) were with mild anemia with 9.3 gm/dl average Hb percentage. Conclusion: The plan of management for anemia complicating pregnancy depends on the type of anemia. Oral iron therapy is the route of choice in women with mild to moderate anemia and for severe anemia in pregnant women &lt;30 weeks of gestation. The rise of Hb with parenteral iron therapy is almost the same (avg: 1gm/dl/week) as that of oral iron therapy.

Ayurvedic Add-on Therapy for β-Thalassemia Major Cases on Quality of Life

Blood transfusions which were suggested as treatment for beta thalassemia major cases brought down the quality of life by several means like splenomegaly, growth retardation, poor appetite, low hemoglobin (Hb), increased serum ferritin level, etc. In present study the group of 79 patients which were selected were having such symptoms arouse due to repeated conventional blood transfusion. the patient was given Amlavetas (Garcinia pedunculata Roxb. ex Buch. Ham) dry fruit pulp (5 g) once daily in the early morning on an empty stomach regularly for 6 months without imposing any restriction to their regular food and other medicines for his existing comorbidities. Objective parameters such as Hb (g%), body weight (Kg), loss of appetite serum ferritin (ng/dl), and frequency of blood transfusion were assessed which ultimately help to understand the QoL of the subjects. The Hb percentage after 3rd month and 6th month was 6.94 ± 1.57 g% and 6.99 ± 1.52 g% which were significant when compared with baseline values (6.42 ± 1.37 g%, P &lt; 0.001). The serum ferritin was significantly increased (P &lt; 0.005) in the follow up visits when compared with baseline value 3112.13 ± 2801.20 ng/dl. The gain in body weight, increase in appetite and reduced blood transfusion rate indicates the quality of life, revealed by the improvement of his blood parameters including the serum ferritin level. Amlavetas fruit pulps can be a potential iron chelating as well as erythropoiesis Ayurvedic intervention to normalize iron metabolism, relieve thalassemia symptoms, and increase BT intervals with better life expectancy.

β-globin variants present in Western Sudan

Objective: A variety of observations of the hemoglobin D (Hgb D) phenotype has occurred in association with family studies of patients with sickle cell disease. Very little is known about the occurrence and prevalence of the Hgb D variant and its impact on blood profiles among Sudanese. This study was aimed at determining the percentage of Hb D in North Darfur State, West Sudan, whose population has been shown to have hemoglobin-S (Hb S) disease. Methods: From December 2017 to August 2018, this descriptive community-based investigation was conducted. Six hundred and sixty-six (666) people were randomly selected to participate in this study. With each participant's there was verbal consent. A questionnaire was designed to collect personal details. 5 mL of venous blood was gathered in EDTA containers. The Hb D variant was checked using Sebia Minicap Automated Capillary Electrophoresis System- USA and frequency was calculated using version 21.0 of the software package for social science (SPSS). Result: The prevalence of Hb variants was as follows: AD=0.6%, SS=2%, AS=10.5 %, and AA=86.9%. Conclusion: The prevalence of Hb D variant was 4 (0.6 %) in 666 participants from four western Sudanese tribes, beside reported of Hb SS and Hb AS.

Treatment modality, diabetic control and blood homeostasis in type 2 diabetes mellitus patients in Basra

Abstract This study is aimed at investigating the relationship between treatment modality, glycemic control and blood homeostasis as represented by prothrombin time (PT) and activated thromboplastin time (APTT) in T2DM patients. Sixty-four type 2 diabetic patients (40 males and 24 females) on metformin or insulin or both for not less than six months of ages between 20 and 75 years were selected during their visit to Diabetes Endocrine and Metabolism Centers in two General Hospitals in Basra. Socioeconomic characteristics and treatment plans were recorded. Glycated haemoglobin (HbA1c), lipid profiles and hematological parameters measured in blood samples were taken. Lower mean HbA1c (p = 0.0383) was found in patients on metformin alone, higher percentage of hemoglobin was found in patients on insulin treatment, and higher levels of LDL (P = 0.0018) and HDL (P = 0.0241) in patients on metformin and insulin. Treatment manner had no effect on mean PT or APTT, however, there was a significant inverse correlation of PT with LDL (P = 0.0042), and a direct correlation of APTT with HbA1c (p = 0.0209) and an inverse correlation of APTT with platelets count (P = 0.0324) in patients on insulin treatment. In addition, there was a significant direct correlation of APTT with triglycerides (TG) (P = 0.0069) in patients on metformin treatment. In conclusion, lower mean of HbA1c was found only in patients receiving metformin drug alone, higher Hb percentage were found in patients treated with insulin alone, higher LDL and higher HDL levels were found in patients treated with both metformin and insulin for at least six months. Treatment manner had no effect on mean PT or APTT and further studies are needed to bring about understanding of diabetic control and blood homeostasis.

Relationship between effects of riociguat and levels of methemoglobin in patients with chronic thromboembolic pulmonary hypertension

Abstract Background Soluble guanyl cyclase (sGC) is a receptor for nitric oxide (NO) and plays an important role in vascular tonus. sGC stimulant is a therapeutic agent for pulmonary hypertension and an advantage of sGC stimulant over phosphodiesterase (PDE)-5 inhibitors is that sGC stimulant exerts its effect even when NO production is reduced. NO derived from vascular endothelial cells is immediately absorbed by hemoglobin (Hb), which leads to the production of methemoglobin (Met-Hb) when oxidized. Previous report has shown that the therapeutic effect of PDE-5 inhibitors was associated with levels of Met-Hb. Purpose In this study, we examined the relationship between the effect of riociguat and levels of Met-Hb in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods The study population comprised 18 patients with CTEPH. Mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) were assessed before and after administration of riociguat, and changes in mPAP and PVR were defined as ΔmPAP and ΔPVR, respectively. Since the level of Met-Hb was obtained as the percentage of Hb (FMet-Hb), the amount of Met-Hb was calculated by following formula: Met-Hb (mg/dL) = Hb (g/dL) × FMet-Hb (%) × 10. Results The amount of Met-Hb value before administration of riociguat was significantly correlated with the degree of improvement in mPAP and PVR after administration of riocigat (R=−0.502, P&amp;lt;0.05 mPAP; R=−0.481, P&amp;lt;0.05 PVR, respectively) as shown in figures. Conclusion Our findings suggest that the level of Met-Hb before treatment may predict the therapeutic effect of sGC stimulants in patients with CTEPH. Funding Acknowledgement Type of funding source: None

Socio-demographic Profile of Patients Admitted in Thalassemia Care Center of Chattogram Maa Shishu-O-General Hospital

Background: Thalassemia is the most common hemoglobin disorder in the worldincluding Bangladesh. Population migration and intermarriage between differentethnic groups have had a major impact on disease epidemiology. To observe theprevalence and specturm of thalassemia as well as demographic and social factorsof thalassemia patients.&#x0D; Materials and methods: This descriptive cross-sectional study was conducted in theThalassemia Care Center of Chattogram Maa Shishu-O-General Hospital,Chattogram from July, 2013 to June, 2014. Parents of 70 thalassemia patients aged2-18 years interviewed with a formulated questionnaire based on social anddemographic characteristics. Data were analyzed by both manually and by SPSS-18.&#x0D; Results: Mean age of patients was 6 years (± 3.66). Near about half of patients(40%) were diagnosed at the age less than 5 years. Mean age of diagnosis was 1.6years (± 1.53 SD). Majority of patients belonged to lower middle class (42.9%) withmale predominance (62.9%). A good number of patients (22.8%) were not engagedin any educational activity. Mean annual income of family was 262000 taka/year ±245477.35 (USD 3324.87 ± 3115.19). Mother contributed to annual income in only4.7% families. The percentage of Hb E/b thalassemia was the highest (54.4%)followed by b thalassemia major (37.1%) and Hb E disease (4.3%). Malepredominance was found in every type of thalassemia. Half of the thalassemiamajor patients were diagnosed during infancy and majority (60.53%) of Hb E/bthalassemia patients were diagnosed at the age less than 5 year.&#x0D; Conclusion: A nation-wide screening program should be carried out to address thecarrier status of population at risk. There may be further analysis regarding clinicaldiversity of thalassemia.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 33-37

PREVALENCE OF HEMOGLOBINOPATHIES IN THE POPULATION OF DIBRUGARH AND IT'S ASSOCIATION WITH SEX

Introduction- Haemoglobinopathies are one of the commonest hereditary disorders in south-east asia and pose a major health problem.The data of their prevalence in the society may help in the future prevention of heath hazards.Materials and method:-Agarose gel electrophoresis was used to study the haemoglobin typing in 118 individuals.The Hb percentage was studied by cyanmethhaemoglobin method.Result:-It was observed that prevalence of abnormal Hb was common in females as compared to males.And moreover in each type of Hb,the percentage of Hb was more in males as compared to females.Conclusion:-Prevalance of abnormal Hb is common in dibrugarh,Their early detection can help in preventing serious health hazards.

Comparison of Combined Lumbosacral Plexus and T12 Paravertebral Nerve Blocks With General Anesthesia in Older Adults Undergoing Primary Total Hip Arthroplasty: A Retrospective, Propensity Score–Matched Cohort Study

Background:Total Hip Arthroplasty(THA) is a surgical treatment for hip disease. A large amount of evidence has been reported on comparing outcomes of neuraxial(spinal or epidural) anesthesia and general anesthesia. However, it is unclear whether nerve blocks(NB) as main anesthesia technique compared with general anesthesia(GA) for THA could reduce perioperative complications. We conducted a retrospective evaluation of NB and GA, using a propensity score-matched analysis(PSMA).Methods:A total of 902 patients older than 60 years old with hip disease undergoing primary THA received combined lumbosacral plexus and T12 paravertebral nerve blocks (n = 143) or GA (n = 759) at our institution from 2012 to 2018.Binary logistic regression was used for comparison of the primary outcomes(the incidence of delirium) and the secondary outcomes(the percentage of postoperative hemoglobin(>10g/dl), transfusion(>2 units), major cardiac events(MACE), postoperative pulmonary complications (PPC) and 30-day mortality) in the matched cohorts.Statistical analysis was performed using SPSS v 23.0.Results:Both cohorts were balanced in all included parameters after PSMA. The incidence of delirium was lower (OR 0.233,95% CI 0.064-0.845, p = 0.030) in NB group in matched cohorts. In the unmatched and matched cohorts, the percentage of Hb(>10g/dl) was higher in GA group but the incidence of transfusion(>2 units) was higher in NB group. No difference was found in the incidence of 30-day mortality in the unmatched and matched cohorts. In the unmatched cohorts, the incidence of PPC was higher and LOS was longer in NB cohort, but no difference was observed in the matched cohorts.Conclusion:In patients older than 60 years old receiving primary THA, NB could be associated with a lower incidence of delirium.

Red Blood Cells Aggregation in the Patients with Type 2 Diabetes and T2D Associated Anemia, a Case Control Study in Bangladesh

Abstract Background and Aims: Type 2 Diabetes (T2D) is a chronic metabolic disorder. Nowadays the number of people with diabetes mellitus is quadrupling in the world as well as in Bangladesh. It is related to different types of disease morbidity and sociodemographic parameters. The present study aimed to investigate the association of RBC aggregation (measured by ESR level) with T2D and T2D associated anemia. Material and method: A total of 234 subjects were included in the study. Sociodemographic and anthropometric information about study subjects were collected using a standard questionnaire. Blood samples were tested for random blood glucose levels, Hb percentage, and ESR. Association of these data with metabolic disorders was analyzed by statistical analysis software, SPSS. Results: This study provides a piece of evidence that anemia is highly prevalent in T2D patients than the healthy control subjects in Bangladesh (59.1% vs 22.5%; P value &lt;0.001). The ESR values were significantly elevated in T2D patients as well as anemic and aged subjects (P value &lt;0.001). Conclusion: The study thus suggests that anemia was prevalent in T2D patients in Bangladesh. The RBC aggregation was significantly elevated in patients with T2D as well as anemia, indicating increased inflammatory response in these diseases.