Red Blood Cell Distribution Width-coefficient Of Variation Research Articles

Sequential Evaluation of Hematology Markers as a Prognostic Factor in Glioblastoma Patients.

In our study, we investigated the prognostic significance of hematological markers-NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width-Coefficient of Variation)-in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with the overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan-Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in the NLR, PLR, and RDW-CV across different treatment stages. The NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p = 0.007, η2p = 0.06; PLR: p = 0.001, η2p = 0.23), while the RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p < 0.001, η2p = 0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, a higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR = 1.03, p = 0.029; RDW-CV at progression: HR = 1.14, p = 0.004). We proposed specific marker cut-offs that demonstrated significant associations with survival outcomes when applied to Kaplan-Meier survival curves (NLR at 2nd line < 5: p < 0.017; RDW-CV at progression < 15: p = 0.007). An elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management.

The elevation of red blood cell distribution width is an independent prognostic factor for juvenile myelomonocytic leukemia.

Juvenile myelomonocytic leukemia (JMML) is a disorder characterized by the simultaneous presence of myeloproliferative and myelodysplastic features, primarily affecting infants and young children. Due to the heterogeneous genetic background among patients, the current clinical and laboratory prognostic features are insufficient for accurately predicting outcomes. Thus, there is a pressing need to identify novel prognostic indicators. Red cell distribution width (RDW) is a critical parameter reflecting the variability in erythrocyte size. Recent studies have emphasized that elevated RDW serves as a valuable predictive marker for unfavorable outcomes across various diseases. However, the prognostic role of RDW in JMML remains unclear. Patients with JMML from our single-center cohort between January 2008 and December 2019 were included. Overall, 77 patients were eligible. Multivariate Cox proportional hazard models showed that patients with red cell distribution width coefficient of variation (RDW-CV) >17.35% at diagnosis were susceptible to much worse overall survival rate (hazard ratio [HR] = 5.22, confidence interval [CI] = 1.50-18.21, P = .010). Besides, the combination of RDW elevation and protein phosphatase non-receptor type 11 (PTPN11) mutation was likely to predict a subgroup with the worst outcomes in our cohort. RDW is an independent prognostic variable in JMML subjects. RDW may be regarded as an inexpensive biomarker to predict the clinical outcome in patients with JMML.

Analysis of hematological indicators via explainable artificial intelligence in the diagnosis of acute heart failure: a retrospective study.

Acute heart failure (AHF) is a serious medical problem that necessitates hospitalization and often results in death. Patients hospitalized in the emergency department (ED) should therefore receive an immediate diagnosis and treatment. Unfortunately, there is not yet a fast and accurate laboratory test for identifying AHF. The purpose of this research is to apply the principles of explainable artificial intelligence (XAI) to the analysis of hematological indicators for the diagnosis of AHF. In this retrospective analysis, 425 patients with AHF and 430 healthy individuals served as assessments. Patients' demographic and hematological information was analyzed to diagnose AHF. Important risk variables for AHF diagnosis were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) feature selection. To test the efficacy of the suggested prediction model, Extreme Gradient Boosting (XGBoost), a 10-fold cross-validation procedure was implemented. The area under the receiver operating characteristic curve (AUC), F1 score, Brier score, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were all computed to evaluate the model's efficacy. Permutation-based analysis and SHAP were used to assess the importance and influence of the model's incorporated risk factors. White blood cell (WBC), monocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), red cell distribution width-standard deviation (RDW-SD), RDW-coefficient of variation (RDW-CV), and platelet distribution width (PDW) values were significantly higher than the healthy group (p < 0.05). On the other hand, erythrocyte, hemoglobin, basophil, lymphocyte, mean platelet volume (MPV), platelet, hematocrit, mean erythrocyte hemoglobin (MCH), and procalcitonin (PCT) values were found to be significantly lower in AHF patients compared to healthy controls (p < 0.05). When XGBoost was used in conjunction with LASSO to diagnose AHF, the resulting model had an AUC of 87.9%, an F1 score of 87.4%, a Brier score of 0.036, and an F1 score of 87.4%. PDW, age, RDW-SD, and PLT were identified as the most crucial risk factors in differentiating AHF. The results of this study showed that XAI combined with ML could successfully diagnose AHF. SHAP descriptions show that advanced age, low platelet count, high RDW-SD, and PDW are the primary hematological parameters for the diagnosis of AHF.

Red Cell Distribution Width-to-Albumin Ratio Is a Simple but Robust Prognostic Biomarker in Peripheral T-Cell Lymphoma

Background: Red cell distribution width (RDW) is the difference in the volume and size of erythrocytes. High RDW has been identified as a worse prognostic factor in various diseases, including sepsis, cerebrovascular accidents, and diverse cancers. More recently, RDW-to-albumin ratio (RAR) is a comprehensive biomarker combining inflammation and nutrition status that better reflects a patient's frailty. However, little is known about its prognostic relevance in peripheral T-cell lymphoma (PTCL), with only one publication focusing on RDW (Castro et al.). Methods: This retrospective analysis included consecutive patients with newly diagnosed PTCL between 2007 and 2023 at Kameda Medical Center. Extranodal NK/T-cell lymphoma, adult T-cell leukemia/lymphoma, and ALK-positive anaplastic large cell lymphoma were excluded due to distinct prognosis and treatment strategies. The RDW coefficient of variation (RDW-CV) was assessed prior to treatment and calculated using the following formula: 1 standard deviation of mean corpuscular volume (MCV) divided by MCV, multiplied by 100. Receiver operating curve (ROC) analysis was used to determine the optimal cutoff value of RDW-CV and RAR for 2-year outcomes. Survival analyses were conducted using Kaplan-Meier curves with log-rank tests, and Cox proportional hazard models were used for univariate and multivariate analyses. Results: In total, 115 patients were included in this analysis. The median age was 74 years (range 45-93), with male predominance (60.8%). Sixty-five patients (56.5%) were initially treated with the CHOP regimen, while 29 patients (25.2%) received more intensive chemotherapy. The most common disease subtype was PTCL-not otherwise specified (49.5%), followed by angioimmunoblastic lymphoma (40.0%). The median RDW-CV and RAR were 14.8 (range 12.2-21.5) and 4.61 (range 2.6-9.8), respectively. The RDW-CV was significantly correlated with levels of hemoglobin (R = -0.4), albumin (R = - 0.59), and lactate dehydrogenase (R = 0.27) (all P &amp;lt; 0.05). ROC curve analysis for 2-year survival revealed a higher area under the curve (AUC) for RAR (0.79) compared to RDW (0.74), with cutoff values of 4.4 and 14.1, respectively (Figure 1). Using this cutoff value, patients with high RAR had significantly worse overall survival (OS) and progression free survival (PFS) than those without (2-year OS rate: 82.5% vs. 35.1%, Figure 2; 2-year PFS rate: 54.8% vs. 27.9%, P &amp;lt;0.001). On multivariate analysis, high RAR was associated with a significantly worse PFS (hazard ratio [HR] =1.89 [95% confidence interval 1.15-3.11], P =0.01) and OS (HR=3.02 [1.66-5.50], P &amp;lt;0.001) independent of the international prognostic index (IPI), dose reduction of chemotherapy and lymphoma subtype. Conclusion: We demonstrated that RAR improved the prognostic stratification compared to RDW-CV alone. Additionally, baseline high RAR was identified as a simple but robust prognostic factor independently associated with IPI category and treatment intensity in PTCL patients.

Evaluation of monocyte to high-density lipoprotein cholesterol ratio and other inflammatory markers in hidradenitis suppurativa: a case-control study

Aims: Hidradenitis suppurativa (HS) is an inflammatory disease whose pathophysiology is not yet clearly known, but inflammatory parameters have been used for many years in the diagnosis and follow-up. The aim of this study is to evaluate NLR, PLR, MHR, and hemogram parameters in patients diagnosed with HS without comorbidities and compare them with healthy controls.&#x0D; Methods: This study include 105 HS patients and 100 healthy volunteers. The medical records and laboratory findings of the participants were reviewed retrospectively. Patients and control group neutrophils, lymphocytes, monocytes, platelets, mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width coefficient of variation (RDW-CV), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and MHR were compared.&#x0D; Results: A total of 105 patients [43 (41%) women and 62 (59%) men] and one hundred healthy volunteers [52 (52%) women and 48 (48%) men] participated in the study. The mean of neutrophil count (patient group=5.84±2.27, control group=4.29±1.81, p=0.001), lymphocyte count (patient group=2.78±0.90, control group=2.31±0.63, p=0.001), monocyte count (patient group=0.74±0.39, control group=0.55±0.16, p=0.001), platelet count (patient group=295.63±65.84, control group=274.45±59.06, p=0.007), CRP (patient group=12.71±24.38, control group=2.61±2.21, p=0.039), and MHR (patient group=0.0203±0.0135, control group=0.0114±0.0056, p=0.001) were higher in the patient whereas the mean of HDL-C (patient group=39.02±11.06, control group=52.85±16.46, p=0.001) and PLR (patient group=118.82±60.82, control group=126.07±39.13, p=0.028) were significantly higher in control individuals. The adjusted effect of MHR, NLR, and PLR was re-examined to eliminate the effect that may arise from the difference in age between patients and controls. It was observed that when MHR increased by 0.01 unit, the risk of disease increased significantly by 4.07 times. When NLR increases by 1 unit, the disease increased. significantly by 1.37 times. Both adjusted and unadjusted effects of MHR were significant. When the sensitivity and specificity of MHR, and NLR in differentiating patients were examined, the sensitivity of MHR was found to be 67.4% and its specificity was 72.5% (p=0.001), while the sensitivity of NLR was found to be 61.5% and its specificity was 74.0% ( p=0.038). &#x0D; Conclusions: Our study showed that MHR was more effective in distinguishing HS patients than other inflammatory markers. MHR can be used as a new marker to investigate the inflammatory effect of HS.

Frequency of Rh-e Antigen and reference values of Erythrocyte Sedimentation Rate and Red Cell Indices in an Undergraduate Students’ population in Port Harcourt, Nigeria.

Introduction: Red cell antigens alongside red cell indices provide an essential support to the diagnosis and monitoring of haematological diseases while the erythrocyte sedimentation rate (ESR) indicates and monitor an increase in inflammatory activity within the body. This study aims to determine Rh-e antigen, Erythrocyte Sedimentation Rate and Red cell indices values in apparently healthy undergraduate students of the Rivers State University, Port Harcourt, Nigeria. Material and Methods: One hundred and fifty (150) undergraduate students aged between 17-28years were enrolled in the study and standard venipuncture technique used to collect 5ml of blood. Determination of the Rh-e antigen was carried out using anti-e monoclonal antibodies (Lorne Diagnostics UK), Red cell indices obtained using BC 5000 Mindray Haematology Analyser and ESR by Westergren method. Results: Among the 150 subjects, 130 (86.6%) were positive while 20 (13.3%) were negative for Rh-e antigen. The mean±SD of the mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), red cell distribution width co-efficient of variation (RDW-CV), red cell distribution width-standard deviation (RDW-SD) and erythrocyte sedimentation rate (ESR) were 83.12 ± 10.74, 31.13 ± 3.25, 34.00 ± 3.32, 13.32 ± 1.61, 39.70 ± 2.26 and 30.36 ± 2.15 in the same order, while the reference ranges were 61.64-104.6 for MCV, 24.63-37.63 for MCH, 27.36–40.64 for MCHC, 10.10–16.54 for RDW (CV), 35.18–44.22 for RDW (SD) and 26.06-34.66 for ESR. Gender had no effect on MCV (p=0.3007) and MCHC (p=0.1436) but significant effect on MCH (p=0.030), RDW-CV (p&lt;0.001), RDW-SD (p=0.0005) and ESR (p=0.036) with a perfect positive correlation (r=1) between all the studied parameters. Conclusion: This study revealed a high (86.6%) prevalence for Rh-e antigen, established normal reference ranges for red cell indices and erythrocyte sedimentation rates and showed that gender has significant effects on MCH, RDW-CV, RDW-SD and ESR among healthy undergraduate students of Rivers State University. These findings are of clinical and research relevance.

Anemia and COVID-19

Objectives: Coronavirus disease-19 (COVID-19) is an infective-inflammatory disease that mainly affects the lungs. Hematological symptoms such as thrombocytopenia, decreased eosinophil and lymphocyte counts are quite common and are of prognostic importance. Although it is known that the presence of anemia generally increases the severity of respiratory diseases, there is little data on the prevalence and importance of anemia in COVID-19. In this study, our aim is to evaluate the clinical features of patients with anemia in COVID-19 infection and to investigate the relationship between the presence of anemia and the prognosis of the disease. Methods: This retrospective, observational study included 353 patients who presented to our pandemic reference hospital between 15.04.2020 and 15.05.2020 and were diagnosed with SARS-CoV-2 infection confirmed by real-time reverse transcription polymerase chain reaction (PCR) test and typical clinical symptoms. Results: Our study included 167 female and 186 male patients. The mean age was 54.54 ± 18.28 years (range 19-99). One hundred forty-eight (41.93%) patients had anemia. In patients with anemia, age was higher than others (p &amp;lt; 0.001). The percentage of women was significantly higher in the anemia group (p &amp;lt; 0.001). Comorbidities were observed more in the anemia group. The percentages of intensive care stay (p = 0.003) and mortality (p = 0.001) were significantly higher in the anemia group compared to the group without anemia. Logistic regression analysis was performed to determine the important risk factors of death. We found patients with high age (p = 0.001), high red cell distribution width-coefficient of variation (RDW-CV) levels (p = 0.009), high D-dimer levels (p = 0.012) and high ferritin levels (p &amp;lt; 0.001) have higher risk of death. Anemia was found to be non-significant. Conclusions: Anemia is frequently observed in patients with severe COVID-19 disease and low hemoglobin values at presentation are thought to be associated with a worse prognosis. Being more sensitive to the hemoglobin levels of COVID-19 patients is important for early recognition of the high-risk patient group and for successful patient management. However, in our study, the presence of anemia was found to be effective in mortality in univariate analysis, but not in multivariate analysis. According to the multivariate analysis of this study, advanced age, high D-dimer, high ferritin and RDW-CV determine death.

A novel nomogram based on the hematological prognosis risk scoring system can predict the overall survival of patients with hepatocellular carcinoma.

This study aimed to establish and validate a nomogram based on a hematological prognostic risk scoring system to predict the overall survival in patients with unresectable hepatocellular carcinoma (HCC). Patients diagnosed with unresectable HCC undergoing transcatheter arterial chemoembolization (TACE) in 2012-2016 and 2017-2018 were included in the development set and validation set, respectively. The clinical outcome was overall survival (OS). The LASSO regression analysis was used to construct a hematological prognostic risk scoring system (HPR) by using the 18 hematological markers of patients in the development set. Combining the features of oncology on the basis of HPR to construct a nomogram for OS. In the development set and validation sets, the C-index, calibration curve, and decision curve analysis (DCA) were used to evaluate the prediction performance of the nomogram. Multiple markers of immunity, coagulation, liver function, and nutrition, including red blood cell distribution width-coefficient of variation (RDW-CV), platelet (PLT), aspartate transferase (AST), alkaline phosphatase (ALP), prognostic nutritional index (PNI), and fibrinogen (Fib), construct the HPR. HPR was an independent risk factor for OS in patients with HCC. The C-index of the nomogram was 0.731 (95% confidence interval (CI) 0.712-0.749) and 0.696 (95% CI 0.668-0.725) in the development set and the validation set, respectively. HPR was a complement to the clinical features of patients with unresectable HCC. The nomogram based on HPR proved to be a practical and effective method for prognosticating HCC patients who undergo TACE.

Erythrocyte Indices in Asymptomatic Malaria Infected Pregnant Women

Background: Red blood cell changes are one of the most common complications in malaria and they play a very crucial role in malaria pathogenesis. Malaria infections are one of the common causes of maternal anaemia especially during pregnancy. The aim of this study was to determine red cell indices of pregnant women with asymptomatic malaria.&#x0D; Place and Duration of Study: Department of Haematology and Antenatal Unit both of Enugu State University of Science and Technology Teaching Hospital, between June and September 2022.&#x0D; Methodology: The study population consisted of 90 pregnant women (65 pregnant women positive to malaria parasite without symptoms and 25 pregnant women negative to malaria parasite) and 26 control non-pregnant women. For the whole study population, red cell indices which include hemoglobin (HGB), packed cell volume (PCV), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width standard deviation (RDW-SD), red cell distribution width coefficient of variation (RDW-CV) were measured by automated haematology analyzer.&#x0D; Results: In the asymptomatic malaria group (AMG), 21 (32.3%) had mild anaemia (HGB level 9.0-10.0 g/dl), 11 (16.9%) had moderate anaemia (HGB level 7.0-8.0 g/dl) and 2 (3.1%) had severe anaemia (HGB level &lt;7.0 g/dl). Also in AMG group, the RDW-SD was 54.22 +/- 11.45 fl, whereas in control group it was 48.75 +/- 10.24 fl (p=0.002). Again in the AMG group the MCHC of those that had two pluses was 318.03 +/- 16.31 g/l, whereas in those that had one plus, it was 309 +/- 20.17 g/l. The comparison between the first, second and third trimester showed significant decrease in HGB (7.63 +/- 1.36 vs 11.64 +/- 0.72 g/dl) and PCV (26.98 +/- 5.14 vs 36.20 +/- 2.19 %) in third trimester compared to first trimester (p= &lt;0.001, &lt;0.001). whereas RDW-CV (18.96 +/- 5.04 vs 15.00 +/- 2.64 %) and RDW-SD (59.04 +/- 15.19 vs 49.16+/- 7.00 fl) (p= 0.002, 0.003) significantly increased in third trimester compared to first trimester&#x0D; Conclusion: This study found anaemia in asymptomatic malaria infected pregnant women, significant decrease in haemoglobin and packed cell volume at third trimester, higher MCHC in those with two pluses of malaria and significant increase in red cell distribution width at third trimester.

P5: Red Blood Cell Distribution Width in Patients with Cardiogenic Shock Supported with Impella 5.5 Temporary Percutaneous Microaxial Left Ventricular Assist Device

Background: Severe cardiogenic shock with metabolic derangement can preclude candidacy to durable left ventricular assist device (LVAD) or cardiac transplant, but may be reversed with temporary mechanical circulatory support. Our primary aim was to determine if red cell distribution width- coefficient of variation (RDW-CV) differed among survivors and non-survivors during their admission with temporary circulatory support. Methods: A series of 27 consecutive patients supported with Impella 5.5 percutaneous microaxial LVAD were reviewed retrospectively. All implants were performed via a tunneled vascular graft anastomosed to the right subclavian artery to allow ambulation. RDW-CV was recorded at admission and at the end of circulatory support. The series was divided into survivors and non-survivors. Groups were compared using Student’s t-test. Results: Surviving patients had a lower percentage of males (79% vs 88%), their cardiomyopathy was more likely to be non-ischemic (58% vs 25%), and were slightly younger (62 vs 69.5 years old) than non-survivors. RDW-CV at the end of Impella support was significantly different between those that survived [median RDW-CV 16.8], and those that did not [median RDW-CV 19.98] (p=0.04). Conclusion: In patients supported with temporary circulatory support with Impella 5.5, RDW-CV is significantly lower among patients that survive to discharge when compared to non-survivors.

Effects of Endocrine Metabolic Factors on Hemocyte Parameters, Tumor Markers, and Blood Electrolytes in Patients with Hyperglycemia.

This study was designed to investigate the effect of endocrine metabolic factors on hemocyte parameters, tumor markers, and blood electrolytes in patients with hyperglycemia. In this study, 1791 patients with hyperglycemia were recruited and grouped according to different testing indexes, and their medical records and laboratory indexes were recorded and analyzed. In adult patients with hyperglycemia, we found that high-density lipoprotein cholesterol (HDL-C) was negatively correlated with white blood cell (WBC) and could exert an effect on WBC; triglyceride (TG) level was positively associated with lymphocyte (LYM#); age, TG, and P affected the level of LYM#; and uric acid (UA) level was positively related to eosinophil (EO#). Besides, age was positively correlated with red blood cell distribution width-coefficient of variation (RDW-CV) level; fasting blood glucose (FBG) and serum phosphorus (P) were negatively correlated with RDW-CV level; and age, creatinine (Cre), FBG, HDL-C, and P were influencing factors of RDW-CV level in adult hyperglycemic patients. HDL-C was negatively correlated with fibrinogen (Fib) level, and age, HDL-C, serum kalium (K), serum sodium (Na), and body mass index (BMI) were the influencing factors of Fib levels. TG was positively associated with neuron-specific enolase (NSE) level and affected the NSE level. Serum magnesium (Mg) was negatively related to carcinoembryonic antigen (CEA) level, and sex, age, FBG, Mg, and BMI could have an effect on CEA level. As well, age and FBG were positively associated with carbohydrate antigen 50 (CA50) levels, UA was negatively correlated with CA50 levels, and age, aspartate aminotransferase (AST), UA, and FBG were the influencing factors of CA50 levels. FBG was negatively related to Mg levels; K, serum zinc (Zn), and fasting C-peptide (C-P) were positively correlated with Mg levels; and FBG, K, Zn, and C-P had an effect on Mg levels. Endocrine metabolic factors are closely related to hemocyte parameters, tumor markers, and blood electrolytes in patients with hyperglycemia.

How to diagnose COVID-19 in family practice? Usability of complete blood count as a COVID-19 diagnostic tool: a cross-sectional study in Turkey

ObjectiveCOVID-19 is currently diagnosed in hospital settings. An easy and practical diagnosis of COVID-19 is needed in primary care. For this purpose, the usability of complete blood count in the...

Evaluate the Complete Blood Picture and Some Biochemical Parameters in Patients referred to the dialysis unit in Diyala General Hospital

Research done on 40 patients; 24 males, 20-79 years, and 16 females, 42-67 years; referred to dialysis unit, Baqubah hospital, in November and December, 2021; January and February 2022. Creatinine, Urea and Iron, record high levels. Glucose, calcium, sodium, potassium, and phosphate, were within normal, and low levels of albumin. Means of Total Erythrocyte Counts (TECs), hemoglobin (Hb), Hematocrit% (HCT), and Mean Corpuscular Hemoglobin Concentration (MCHC), showed lowered level. While, Mean Cell Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Red Blood Cell Distribution Width- Standard Deviation (RDW-SD), Mean Red Blood Cell Distribution Width- Coefficient of Variation (RDW-CV), were within normal. Total Leucocyte Counts (TLCs), Neutrophils, Lymphocytes, Eosinophil, Basophils, were within normal, Platelet Counts and related parameter were within normal. Within ranges some values were higher than normal as, potassium, phosphate, (RDW-SD), (RDW-CV), Neutrophils%, Eosinophil%, Lymphocytes, Mean Platelets Volume (MPV). While some other values were lower as sodium, (TRCs), (Hb), (HCT %), (MCV), (MCH), (MCHC), (RDW-SD), (TLCs), Lymphocytes%, platelets, Platelet Distribution Width (PDW), Platelet- Large Cell Ratio (P-LCR). But some values of glucose, and calcium, were high, and some other low. At the same time Monocytes%, Basophils% was within normal range. In conclusion creatinine and urea levels have an important role in diagnosis and follow- up of kidney failure. All patients have high levels of urea, iron and creatinine. But not all have higher level of potassium and glucose. Sodium and albumin, showed decreased level. Blood picture revealed microcytic, hypochromic anemia; as (TECs), (Hb), (HCT %), (MCHC) and (RDW-SD) were of lower values.

Correlation Analysis between c.1365-13T>C and c.406C>T Single Nucleotide Polymorphism and the Risk of G6PD Deficiency

To investigate the possible association between c.1365-13T>C, c.406C>T polymorphism and G6PD deficiency in the population of Guangxi by the methods of case-control study. Meanwhile to investigate the mutation frequency of these two gene loci in population of Guangxi. The activity levels of G6PD and c.1365-13T>C, c.406C>T polymorphism were detected in 417 patients with G6PD deficiency and 295 healthy controls. The correlation between genotypes, alleles and G6PD activity levels was analyzed using statistical methods, and the haplotype frequencies at the two loci was analyzed using online SHEsis software. The frequencies of CC genotype (P=0.001, OR=2.684) and C allele (P=0.002, OR=1.681) of c.1365-13T>C in patients with G6PD deficiency were significant lower than those in the controls, the frequency of dominant model TT+TC vs CC（P=0.001, OR=2.694） in the G6PD deficiency group was higher than that in the control group, and the differences were statistically significant. The differences of genotype and allele frequencies in c.406C>T between G6PD deficiency patients and controls had no statistical significance (all P>0.05). Haplotype analysis showed that there were significant correlations between C-C, T-C haplotypes and G6PD expression levels. In G6PD deficiency group, patients with c.1365-13T>C TC genotype had higher levels of G6PD activity, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) compared with patients with TT genogype, but the values of red cell distribution width-coefficient of variation (RDW-CV) was lower than those in TT genotype patients, and the differences were statistically significant (P<0.05). While patients with c.1365-13T>C CC genotype had lower levels of G6PD activity compared with patients with TT genogype, but the values of MCV and MCH were higher than those in TT genotype patients (P<0.05). The average values of hematocrit(HCT), MCV, MCH and red blood cell distribution width-standard deviation (RDW-SD) in patients with c. 406C> T TT genotype were significantly higher than those in patients with c. 406C> T CC genotype.(all P<0.05). The association between G6PD c.1365-13T>C and the activity levels of G6PD is statistically significant, which is worth further study.

Relationship between red blood cell-related indices and coronary artery calcification.

Red blood cell (RBC) indices such as RBC count and RBC distribution width (RDW) are associated with heart failure and coronary artery disease, but the relationship between RBC indices and coronary artery calcification (CAC) is unclear. This study aimed to investigate RBC indices' correlation with, and predictive value for, the presence and severity of CAC. In this study, 1257 hospitalized patients who received a coronary computed tomography angiography examination were finally selected. Patients were classified into a control group (without CAC, n = 655) and a calcification group (with CAC, n = 602) according to their CAC score. The calcification group was further divided into a low calcification group, medium calcification group, and high calcification group. In the calcification group, the RBC count was lower, and the RDW-standard deviation (SD) and RDW-coefficient of variation (CV) were higher, than those in the control group (P < .05). In the high calcification group, the RBC count was significantly lower, and the RDW-SD and RDW-CV were significantly higher, than those in the low calcification group (P < .05). Multivariate logistic regression analysis showed that RBC count, RDW-SD, and RDW-CV were independent predictors of CAC presence. Furthermore, multivariate logistic regression analysis also showed that RBC count and RDW-SD were independent predictors of severe CAC. RBC indices were significantly associated with the presence and severity of CAC, indicating that these RBC indices have the potential to be predictors of CAC.

Prevalence and spectrum of haemoglobinopathies in females of reproductive age group- A first tertiary care center experience in Punjab, North India.

Thalassemia and hemoglobinopathies are a group of inherited conditions characterized by abnormalities in the synthesis or structure of hemoglobin (Hb). According to estimates, approximately 7% of the world population is a carrier of Hb disorders, leading to high morbidity and mortality. To reduce the burden of these highly prevalent monogenic disorders, detecting them in the carrier stage is crucial to prevent disease progression. We aimed to estimate the prevalence and spectrum of hemoglobinopathies in females in the reproductive (20-40 years) age group. It was a retrospective observational study carried out for 2.5 years (from January 2018 till June 2020). All the females in the age group of 20-40 years age whose blood samples were received in the department for High-Performance Liquid Chromatography (HPLC) were included. The cases with abnormal HPLC findings were analyzed for hematological parameters including hemoglobin, RBC count, and RBC indices [mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), & red cell distribution width - coefficient of variation (RDW-CV)]. Statistical package for social science (SPSS) statistics 21 version for Microsoft Windows (Chicago, USA) was used for statistical analysis of data. The data were described in terms of range, mean ± standard deviation (SD), frequencies (number of cases), and relative frequencies (percentage) as appropriate. During the study period, 72.2% of the females were affected with β-thalassemia trait, followed by HbD Punjab trait (17.8%), HbQ India trait (2.9%), β-thalassemia major (1.8%), and two cases (1.2%) each of HbS trait, HbD Iran trait, and compound heterozygous of HbD Punjab and β-thalassaemia, whereas HbE trait, compound heterozygous of HbQ and β-thalassemia, compound heterozygous of HbJ-variant and β-thalassemia had one case each (0.6%). Preventive strategies are cost-effective and include population screening, premarital screening, screening of spouses, genetic counseling, and prenatal diagnosis. Educating the carrier females about the potential risk and various screening methods may help in controlling the disease.

Red Cell Distribution Width and Platelet Indices in Women with Pre-eclampsia: A Cross-sectional Study

Introduction: To determine the prognosis and fetomaternal outcome in eclampsia and pre-eclampsia, a simple and costeffective approach is to assess the Red cell Distribution Width (RDW) and platelet count. RDW, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and platelet markers such as Mean Platelet Volume (MPV) have been the subject of research. Aim: To compare the variation of RDW, NLR, PLR, and platelet indices between women with pre-eclampsia and gestational age-matched healthy controls. Materials and Methods: A cross-sectional study was conducted among 208 pregnant women (104 with pre-eclampsia and 104 controls) at the Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, from January 2020 to June 2021. RDW, NLR, PLR, and platelet indices were analysed after obtaining detailed history, conducting clinical examinations, and relevant investigations. An Independent t-test was used as a test of significance to identify the mean difference between the two quantitative variables. Results: The RDW among cases was 17.05±4.01, whereas among controls, it was 15.09±1.86. The mean age of subjects among case group was 25.72±4.741 years, while in the control group it was 23.25±3.803 years. There was a significant difference in mean Red cell Distribution Width- Coefficient of Variation (RDW-CV) between the two groups. The MPV among cases was 9.86±1.14, while among controls, it was 8.92±1.40 (p-value=0.001). The PDW among cases was 11.30±2.20, and among controls, it was 12.72±3.50. The mean NLR among cases was 5.92±4.94, whereas among controls, it was 4.59±2.22. There was a significant difference in mean platelet count, MPV, PDW, and NLR between the two groups. Conclusion: According to the findings of the current study, RDW, NLR, and MPV were all shown to be higher in women with pre-eclampsia. Additionally, pre-eclamptic women consistently exhibited decreased PDW and platelet counts.

A Scoring System Based on Laboratory Parameters and Clinical Features to Predict Unfavorable Treatment Outcomes in Multidrug- and Rifampicin-Resistant Tuberculosis Patients.

The growth of antibiotic resistance to Mycobacterium TB represents a major barrier to the goal of "Ending the global TB epidemics". This study aimed to develop and validate a simple clinical scoring system to predict the unfavorable treatment outcomes (UTO) in multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) patients. A total of 333 MDR/RR-TB patients were recruited retrospectively. The clinical, radiological and laboratory features were gathered and selected by lasso regression. These variables with area under the receiver operating characteristic curve (AUC)>0.6 were subsequently submitted to multivariate logistic analysis. The binomial logistic model was used for establishing a scoring system based on the nomogram at the training set (N = 241). Then, another independent set was used to validate the scoring system (N = 92). The new scoring system consists of age (8 points), education level (10 points), bronchiectasis (4 points), red blood cell distribution width-coefficient of variation (RDW-CV) (7 points), international normalized ratio (INR) (7 points), albumin to globulin ratio (AGR) (5 points), and C-reactive protein to prealbumin ratio (CPR) (6 points). The scoring system identifying UTO has a discriminatory power of 0.887 (95% CI=0.835-0.939) in the training set, and 0.805 (95% CI=0.714-0.896) in the validation set. In addition, the scoring system is used exclusively to predict the death of MDR/RR-TB and has shown excellent performance in both training and validation sets, with AUC of 0.930 (95% CI=0.872-0.989) and 0.872 (95% CI=0.778-0.967), respectively. This novel scoring system based on seven accessible predictors has exhibited good predictive performance in predicting UTO, especially in predicting death risk.

Development of a complete blood count with differential-based prediction model for in-hospital mortality among patients with acute myocardial infarction in the coronary care unit.

PurposeIn recent years, the complete blood count with differential (CBC w/diff) test has drawn strong interest because of its prognostic value in cardiovascular diseases. We aimed to develop a CBC w/diff-based prediction model for in-hospital mortality among patients with severe acute myocardial infarction (AMI) in the coronary care unit (CCU).Materials and methodsThis single-center retrospective study used data from a public database. The neural network method was applied. The performance of the model was assessed by discrimination and calibration. The discrimination performance of our model was compared to that of seven other classical machine learning models and five well-studied CBC w/diff clinical indicators. Finally, a permutation test was applied to evaluate the importance rank of the predictor variables.ResultsA total of 2,231 patient medical records were included. With a mean area under the curve (AUC) of 0.788 [95% confidence interval (CI), 0.736–0.838], our model outperformed all other models and indices. Furthermore, it performed well in calibration. Finally, the top three predictors were white blood cell count (WBC), red blood cell distribution width-coefficient of variation (RDW-CV), and neutrophil percentage. Surprisingly, after dropping seven variables with poor prediction values, the AUC of our model increased to 0.812 (95% CI, 0.762–0.859) (P < 0.05).ConclusionWe used a neural network method to develop a risk prediction model for in-hospital mortality among patients with AMI in the CCU based on the CBC w/diff test, which performed well and would aid in early clinical decision-making. The top three important predictors were WBC, RDW-CV and neutrophil percentage.

Is red blood cell distribution width a prognostic factor for colorectal cancer? A meta-analysis.

BackgroundRDW might be an easy and cost-effective pre-operative prognostic factor for cancer patients. The aim of the current study was to analyze whether red blood cell distribution width (RDW) was a prognostic factor for colorectal cancer (CRC) patients who underwent radical surgery.MethodsWe conducted the searching strategy in three databases including the PubMed, Embase and Cochrane Library from the inception to May 07, 2022, to find eligible studies. In this meta-analysis, we focused on the prognosis. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS).ResultsA total of seven studies involving 7,541 patients were included in this meta-analysis. After pooling up the HRs, red blood cell distribution width-coefficient of variation (RDW-CV) was not an independent prognostic factor of OS (HR = 1.48, I2 = 90%, 95% CI = 0.93 to 2.36, P = 0.10), however, red blood cell distribution width-standard deviation (RDW-SD) was an independent prognostic factor of OS (HR = 1.99, I2 = 0%, 95% CI = 1.59 to 2.49, P < 0.01). As for DFS, we found that RDW-CV (HR = 1.51, I2 = 83%, 95% CI = 0.94 to 2.43, P = 0.09 < 0.10) and RDW-SD (HR = 1.77, I2 = 56%, 95% CI = 0.91 to 3.43, P = 0.09 < 0.10) were both the independent prognostic factors. In terms of CSS, we found that RDW-CV was not an independent prognostic factor (HR = 1.23, I2 = 95%, 95% CI = 0.72 to 2.10, P = 0.46).ConclusionRDW-SD was an independent prognostic factor of OS and DFS, and RDW-CV was an independent prognostic factor of DFS.