Red Blood Cell Morphology Research Articles

Changes in morphofunctional parameters of erythrocytes and oxygen-binding capacity of hemoglobin under the influence of microorganisms of various types.

When bacteria interact with red blood cells, the plasma membrane receives signals from the microorganism adhesins, and the functional work of the erythrocyte as a whole depends on the biomembrane phospholipid condition. However, the microorganism effect on the structural and functional properties of the red blood cell membrane, as well as on the hemoglobin oxygen-binding ability has not been studied enough. Given the foregoing, we sought to study these issues in our work. The study used the "bacteria-red blood cells" model, using archival microbial strains (Staphylococcus aureus, Escherichia coli, Mycolicibacterium rutilum, and M. iranicum) and donor erythrocytes. The structural and functional properties of the red blood cell membrane phospholipids and the spectral characteristics of the hemoglobin molecule were studied using Raman spectroscopy. To study changes in red blood cell (RBC) morphology under the impact of microorganisms, laser interference microscopy was used. The results show that various types of microorganisms affected the conformational structure of the RBCs membrane phospholipid bonds, which contributed to changes in the morphological characteristics of cells, resulting in functional changes in both the red blood cell as a whole and the main RBC oxygen transport protein-hemoglobin.

Poisoned in their homes - Red blood cell abnormalities in lead-exposed residents of a Pakistani Industrial Zone.

The present study investigated the clinical and hematological effects of chronic lead exposure in the population residing in Shadi Pura, a small industrial zone in Lahore, Pakistan. A cross-sectional analysis of 149 participants recruited through health camps was conducted to explore the hematological manifestations of environmental lead exposure, focusing on various red blood cell (RBC) indices and morphology. Moreover, the study examined the differences in the impact of lead exposure on RBC indices and morphology between men, women, and children. Participants exhibited symptoms of lead poisoning, including fatigue, muscle pain, and headache, with a significant percentage of women (44%) reporting miscarriages. Iron deficiency anemia was highly prevalent among all sub-groups of the study population, with adult females showing a significantly higher prevalence than adult males. Male children were the most affected subgroup, with 93% displaying anemia. The RBC count in children remained unchanged, while 31% of male and 7% of female participants displayed elevated RBC counts. RBC indices, mainly mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), were below normal levels, with children being more affected than adults and adult males being the least affected group. Furthermore, RBC morphology was severely affected, with a considerable proportion of females and children displaying hypochromic microcytic morphology. Our results highlight variations in the hematological impacts of lead exposure in different sex and age cohorts. Overall, our findings underscore the urgency of addressing the issue of environmental lead exposure in similar industrial zones. It is critical to implement appropriate measures to reduce lead exposure and enhance the infrastructure for safe drinking water and waste disposal to protect the health of populations in such areas.

P0763 Beyond Anaemia: Changes in Iron Reserves during the Treatment of Crohn's Disease

Abstract Background Alterations of iron metabolism in Crohn's disease (CD) adversely affect patients’ quality of life, with anaemia being a main clinical manifestation. The causes of anaemia in CD are multifaceted. Our goal is to outline the initial iron metabolism features in a treatment-naïve CD cohort, offering clinical insights to enhance therapeutic approaches. Methods We enrolled CD patients from a prospective inception cohort between July 2019 and June 2022 undergoing treatment with tumour necrosis factor antagonists and collected results of blood routine tests, C-reactive protein, iron metabolism markers, and plasma samples at the time of diagnosis. Follow-up for 70 patients was conducted 3-6 months post-treatment, with hepcidin levels measured using enzyme-linked immunosorbent assay kits. Results In our baseline analysis of 141 CD patients, 106 were male (75.2%) with a median diagnostic age of 25 (Table). Anaemia was present in 73 patients (51.8%), with 9 having moderate anaemia (12.3%). Three patients received oral iron during follow-up. Patients were categorized into three ferritin-based groups: 33 in Group 1 (ferritin <30, 23.4%), 58 in Group 2 (ferritin 30-100, 41.1%), and 50 in Group 3 (ferritin >100, 35.5%). Group 1 had the fewest male patients (54.4% vs. 81%/82%, P < 0.017), while Group 3 had the highest C-reactive protein and the lowest albumin levels. Group 1 had lower white blood cell (6.5 vs. 7.8, P = 0.007), neutrophil counts (4.5 vs. 5.4, P = 0.01), and less colorectal involvement (45.4% vs. 78.0%, P = 0.004) than Group 3. Group 1 had a higher proportion of anaemia (66.7% vs. 39.7%, P = 0.013), and lower values in red blood cell morphology parameters compared to Group 2. Ferritin correlated strongly with hepcidin (r=0.835, P < 0.001), and transferrin moderately (r=-0.571, P < 0.001). In the follow-up of 70 patients (Figure A), anaemia state and abnormal Mean corpuscular volume significantly improved after biological therapy (51.4% vs. 14.3% and 65.7% vs. 32.9%, respectively), while the proportion of patients in Group 1 increased significantly (21.4% vs. 42.9%). Further analysis of iron metabolism indicators before and after treatment (Figure B) revealed significant decreases in hepcidin and ferritin, and a significant increase in transferrin across all three ferritin-based groups. Conclusion Iron metabolism disruptions and insufficient iron reserves contribute to anaemia in CD, which correlates with sex, disease location, and the severity of inflammation. After biological therapy, anaemia significantly improved, but iron reserve indicators decreased. The anaemia improvement seems due to reduced inflammation rather than iron supplementation, highlighting the need to monitor iron reserves to refine anaemia management in CD.

Dissociation of IgM antibodies from red blood cells using ethylenediamine tetraacetate/glycine acid or chloroquine diphosphate.

Ethylenediamine tetraacetate/glycine acid (EGA) and chloroquine diphosphate (CDP) are used in transfusion testing to dissociate IgG antibodies from red blood cells (RBCs). However, the ability of these reagents to dissociate IgM antibodies sensitized to RBCs has not been comprehensively elucidated. We investigated whether EGA and CDP could dissociate cold-reactive antibodies from RBCs and their effect on RBCs after dissociation treatment. Cold-reactive antibody-sensitized RBC samples were prepared by mixing group A RBCs and group B plasma and treated with EGA, CDP, and dithiothreitol (DTT). Before and after the dissociation treatment, changes in the agglutination of these RBCs were assessed using the test tube method. Flow cytometric analysis was used to confirm the nature of antibodies bound to RBCs. Additionally, RBC morphology was evaluated using scanning electron microscopy. This study utilized off-label use of EGA and CDP. Flow cytometric analysis showed that antibodies sensitized to RBCs were mainly IgM antibodies. After antibody dissociation, agglutination disappeared in the EGA-treated samples to the same degree as in the DTT-treated samples. However, IgM antibodies remained in the CDP-treated samples. Regarding RBC morphology, RBC surface appeared coarser in both EGA- and CDP-treated samples, and RBC area was significantly smaller in the CDP-treated samples than in the EGA-treated samples. EGA could dissociate cold-reactive antibodies, whereas CDP had a higher residual antibody content. This difference in dissociation ability appears to correlate with the antibody pH of the dissociation reagent. EGA treatment may be useful in cases of sensitization by high-titer cold-reactive antibodies.

Effect of Chlorpyrifos on the Red Blood Cells Morphology of Common Carp (Cyprinus Carpio): A Hematological Study

Chlorpyrifos, a widely applied insecticide, enters waterways through runoff, affecting a wide range of aquatic species. The environmental impact of chlorpyrifos (CPF), a commonly used organophosphate pesticide, on aquatic organisms remains a significant concern due to its toxicity and persistence in ecosystems. This study evaluates the effects of CPF on the morphology of red blood cells (RBCs) in the common carp (Cyprinus carpio) to better understand its hematological toxicity. Common Carp were exposed to sublethal concentrations of CPF (0, 10, 20, and 30 µL) for duration of seven days. Blood samples were collected and examined for alterations in RBC morphology. Control specimens showed minimal morphological changes which were due to natural conditions, while CPF exposure induced a concentration-dependent increase in cellular abnormalities, including double nucleated cells, nuclear displacement, cell deformation, and fragmentation. The highest CPF concentration (30 µL) resulted in severe RBC damage, including nuclear pyknosis, loss of cell integrity, and necrosis. These findings suggest that CPF exposure leads to significant erythrocyte damage, which may compromise overall fish health and survival. The results underscore the need for stringent environmental monitoring and regulation of pesticide use to mitigate its detrimental effects on aquatic life.

Clinical and Hematological Characteristics of Patients with Fast Moving Hemoglobins Diagnosed in a Tertiary Level Laboratory

Objective: To analyze hematological and clinical characteristics of fast-moving hemoglobin variants. Study Design: Descriptive cross-sectional. Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from March 2021 to March 2022. Methodology: A total of 637 patients, enrolled over a period of two years, were included in this cross-sectional study. Inclusion criteria comprised of all patients reporting for hemoglobin studies for screening hemoglobin disorders. Sysmex XN 3000 automated hematology analyzer was used to perform complete blood counts, peripheral blood smears were assessed for red blood cell morphology and hemoglobin electrophoresis was done using three parallel techniques. Results: Fast moving hemoglobins were diagnosed in 12(1.8%) patients, with a male to female ratio of 0.8:1 and mean age of 25.6±15.1 years. Clinical presentations of the patients included anemia in 7(58%) and transfusion history in 3(25%) patients. Peaks of Hb H and J were seen on Sebia capillary zone electrophoresis, in zones of Z15 (20-40 seconds) for Hb H and Z12 (80-100 seconds) for Hb J respectively. Retention times at High Performance Liquid Chromatography of Hb H and Hb J were 0.39 and 0.6 mins respectively. Cellulose acetate membrane revealed fast moving bands in all patients. Conclusion: Fast moving hemoglobins remain an underdiagnosed entity, needing urgent allocation of resources for assisting patients in diagnosis and management.

AneRBC dataset: a benchmark dataset for computer-aided anemia diagnosis using RBC images.

Visual analysis of peripheral blood smear slides using medical image analysis is required to diagnose red blood cell (RBC) morphological deformities caused by anemia. The absence of a complete anaemic RBC dataset has hindered the training and testing of deep convolutional neural networks (CNNs) for computer-aided analysis of RBC morphology. We introduce a benchmark RBC image dataset named Anemic RBC (AneRBC) to overcome this problem. This dataset is divided into two versions: AneRBC-I and AneRBC-II. AneRBC-I contains 1000 microscopic images, including 500 healthy and 500 anaemic images with 1224 × 960 pixel resolution, along with manually generated ground truth of each image. Each image contains approximately 1550 RBC elements, including normocytes, microcytes, macrocytes, elliptocytes, and target cells, resulting in a total of approximately 1 550 000 RBC elements. The dataset also includes each image's complete blood count and morphology reports to validate the CNN model results with clinical data. Under the supervision of a team of expert pathologists, the annotation, labeling, and ground truth for each image were generated. Due to the high resolution, each image was divided into 12 subimages with ground truth and incorporated into AneRBC-II. AneRBC-II comprises a total of 12 000 images, comprising 6000 original and 6000 anaemic RBC images. Four state-of-the-art CNN models were applied for segmentation and classification to validate the proposed dataset. Database URL: https://data.mendeley.com/preview/hms3sjzt7f?a=4d0ba42a-cc6f-4777-adc4-2552e80db22b.

Mathematical Modeling of Mechanical Forces and Chemical Reaction Dynamics for Restoring Shape Memory in Sickle-Cell Red Blood Cells

Sickle cell disease (SCD) is a genetic disorder that causes red blood cells (RBCs) to deform into a sickle shape, leading to vaso-occlusion and impaired blood flow. This study develops a mathematical model to investigate the mechanical forces and chemical reactions involved in restoring the shape memory of sickled RBCs. We examined the effects of various forces and chemical compositions on RBC morphology, elasticity, and functionality. Our results demonstrated that optimal chemical reactions and mechanical forces can significantly restore the shape memory of sickled RBCs and improve their oxygen-carrying capacity. Specifically, increased chemical reactions generate stretching forces that enhance RBC elasticity, reduce stickiness, and facilitate shape recovery. Additionally, mechanical forces help dismantle abnormal hemoglobin structures, aiding in the restoration of normal RBC morphology. The presence of normal hemoglobin in heterozygous individuals also contributes to reduced sickling and improved RBC function. These findings provide critical insights into potential therapeutic strategies for alleviating the symptoms of sickle cell disease and enhancing patient outcomes.

Digital Imaging of Peripheral Blood Smear With MC-80 as a Screening Tool for Thalassemia.

Thalassemia, a genetic blood disorder, poses significant global health challenges, emphasizing the importance of accurate screening methods. Traditional diagnostic tools, such as osmotic fragility and dichlorophenolindophenol tests, along with blood indices, such as mean corpuscular volume and mean corpuscular hemoglobin, have limitations. Digital microscopy of peripheral blood smears is a promising alternative for objective quantification and standardization. Blood samples from 81 thalassemia screening-negative and 41 screening-positive individuals were analyzed using Mindray MC-80 Digital Morphology. Pre-classification of red blood cell (RBC) morphology using Mindray MC-80 revealed significant differences between the screening-positive and screening-negative groups. Various RBC morphologies demonstrated statistically significant variance, including hypochromic cells, schistocytes, elliptocytes, target cells, teardrop cells (p < 0.001), and ovalocytes (p = 0.002). However, the area under the receiver operating characteristic curve of these parameters was < 0.8, indicating a limited discriminatory power. RBC morphology showed promise in detecting subtle changes associated with thalassemia. However, it may not be sufficient for accurate screening alone, highlighting the need for complementary diagnostic approaches.

Rheology and Morphological Study of Anaemic Red Blood Cell Parameters Irradiated with Blue and Green Laser Beam

Numerous studies have explored the effects of low-level laser therapy (LLLT) on blood parameters over the past decade. This study investigates the in vitro effects of blue and green laser light on the rheological properties and morphology of anemic human red blood cells (RBCs). A total of 36 blood samples were collected and analyzed before and after laser irradiation at exposure times of 30, 60, and 90 seconds. Key blood parameters, including hematocrit (HCT), mean cell volume (MCV), and mean corpuscular hemoglobin (MCH), were measured immediately after irradiation using a hematology analyzer, followed by morphological evaluation. Significant changes were observed in HCT and MCV for both blue and green laser irradiation. Notably, RBC deformability increased, particularly after 90 seconds of laser exposure. The findings demonstrate that anemic samples are more affected by laser irradiation than normal samples, with green laser showing a greater impact on RBC morphology compared to blue laser

An empirical study of object detection models for the detection of iron deficiency anemia using peripheral blood smear images

Abstract Iron Deficiency Anemia (IDA) is the nutritional disorder that occurs when the body does not contain enough iron, an essential component of hemoglobin (Hb). The World Health Organization (WHO) estimated that IDA is the main cause of anemia in 1.62 billion cases worldwide [1]. Although IDA rarely results in death, it has significant adverse impacts on human health. During diagnosis, the hemoglobin indices show low mean corpuscular hemoglobin and mean corpuscular hemoglobin volume. On Peripheral Blood Smear (PBS) images viewed under a microscope by hematologists, IDA shows hypochromic and microcytic red cells. The purpose of the proposed research is to develop a computer-aided system that will allow hematologists to diagnose and detect diseases more accurately and quickly, therefore saving them time and effort. In order to diagnose or detect clinical disorders, non-invasive techniques like machine learning algorithms are employed. This work aims to identify IDA by utilizing the RetinaNet-Disentangled Dense Object Detector (DDOD) to localize hypochromic microcytes in PBS images. To the best of our knowledge, this is the first work using the object detection technique to detect IDA based on the Red Blood Cell (RBC) morphology. We carried out an extensive quantitative and qualitative evaluation of the model. Additionally, a comparison was made between the performance of our model and other object detection models. The results showed that our approach outperformed state-of-the-art techniques, with a mean average precision that was more than 8% higher.

Correlation of Red Blood Cell Morphology with Serum Cobalamin and Folate Concentration in Dogs with Chronic Diarrhea: A Retrospective Study.

Background/Objectives: Chronic diarrhea in dogs is a prevalent condition that significantly impacts canine health, often leading to weight loss, dehydration, and malnutrition. Diagnosing and treating chronic diarrhea is challenging due to its multifactorial nature, necessitating collaboration among veterinarians across various specialties. Measuring cobalamin and folate levels is a crucial diagnostic step for all dogs with chronic diarrhea. The role of these vitamins in erythropoiesis is well-documented in human medicine, where deficiencies are linked to erythropoietic disorders and megaloblastic anemia. This study explores the relationship between cobalamin and folate concentrations with hematologic parameters in dogs with chronic diarrhea to develop novel diagnostic methods that facilitate timely decision making. Methods: Forty-seven adult dogs with a history of chronic diarrhea (2019-2023) were included in the study. Upon presentation, complete blood count and measurement of cobalamin and folate concentrations were performed. The correlation of cobalamin and folate levels with erythrocytic parameters, including hematocrit (HCT), hemoglobin concentration (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and reticulocyte count, as well as morphological changes in the blood smear were examined. Results: Serum cobalamin was significantly correlated with RBC (p = 0.032), HGB (p = 0.006), HCT (p = 0.005), and MCV (p = 0.022). Anisocytosis was significantly correlated with hypocobalaminemia (p = 0.002), while acanthocytosis correlated with normal cobalamin levels (p = 0.046). No correlation was found between serum folate and erythrocytic parameters or morphological changes. Conclusions: These findings emphasize cobalamin's potential role in canine erythropoiesis, highlighting the need for routine evaluation and supplementation when necessary. Conversely, the lack of association with folate suggests it plays a less significant role in this species. These results underscore the importance of complete blood count in the diagnostic investigation of dogs with chronic diarrhea.

Red Blood Cell Morphology Is Associated with Altered Hemorheological Properties and Fatigue in Patients with Long COVID.

SARS-CoV-2 infection adversely affects rheological parameters, particularly red blood cell (RBC) aggregation and deformability, but whether these changes persist in patients suffering from Long-COVID (LC) and whether these changes are related to RBC morphology remain unknown. Venous blood was collected from n = 30 diagnosed LC patients and n = 30 non-LC controls and RBC deformability, RBC aggregation, and hematological parameters were measured. In addition, RBCs were examined microscopically for morphological abnormalities. The mechanical sensitivity index (MS) was assessed in n = 15 LC and n = 15 non-LC samples. Hematological parameters did not differ between the groups. However, LC showed higher aggregation-related parameters. Although RBC deformability was higher in LC, MS, reflecting the functional capacity to deform, was limited in this group. RBCs from LC showed significantly more morphological abnormalities. The extent of morphological abnormalities correlated with MS and the FACIT-Fatigue score of the LC patients. RBCs from LC show a high degree of morphological abnormalities, which might limit the blood flow determining RBC properties and also be related to fatigue symptomatology in LC. Approaches are now needed to understand the underlying cause of these alterations and to ameliorate these permanent changes.

Hydrogen peroxide diffusion across the red blood cell membrane occurs mainly by simple diffusion through the lipid fraction

Hydrogen peroxide (H2O2) is an oxidant produced endogenously by several enzymatic pathways. While it can cause molecular damage, H2O2 also plays a role in regulating cell proliferation and survival through redox signaling pathways. In the vascular system, red blood cells (RBCs) are notably efficient at metabolizing H2O2. In addition to a robust antioxidant defense, we recently determined that human RBCs also have a high membrane permeability to H2O2 that is independent of aquaporin 1 or aquaporin 3. In this work, we sought to further investigate the permeation mechanism of H2O2 through the membrane of human RBCs. First, we explored the role of other erythrocytic membrane proteins in H2O2 transport, including urea transporter B and ammonia transporter Rh proteins. However, no differences were found in H2O2 permeability in RBCs lacking these proteins compared to control RBCs. We then focused on the hypothesis that H2O2 diffuses through the lipid bilayer. To test this, we studied H2O2 permeability in RBCs from patients with Gaucher disease (GD), which accumulate sphingolipids in the membrane, affecting RBC morphology and deformability. We found that RBCs from GD patients exhibited lower H₂O₂ membrane permeability. In another approach, we treated normal RBCs with hexanol, which fluidizes the lipid fraction of the RBC membrane, and observed an increase in the permeability to H2O2. In contrast, hexanol had no effect on the rate of water efflux by aquaporin 1. Together, these results support the hypothesis that H2O2 diffusion through the RBC membrane occurs primarily through the lipid fraction.

Increased exercise tolerance in humanized G6PD-deficient mice

Glucose-6-phosphate dehydrogenase (G6PD) deficiency affects 500 million people globally, affecting red blood cell (RBC) antioxidant pathways and increasing susceptibility to hemolysis under oxidative stress. Despite the systemic generation of reactive oxygen species during exercise, the effects of exercise on individuals with G6PD deficiency remain poorly understood This study used humanized mouse models expressing the G6PD Mediterranean variant (S188F, with 10% enzymatic activity) to investigate exercise performance and molecular outcomes. Surprisingly, despite decreased enzyme activity, G6PD-deficient mice have faster critical speed than mice expressing human canonical G6PD. After exercise, deficient mice did not exhibit differences in RBC morphology or hemolysis, but had improved cardiac function, including cardiac output, stroke volume, sarcomere length, and mitochondrial content. Proteomics analyses of cardiac and skeletal muscles (gastrocnemius, soleus) from G6PD-deficient compared with sufficient mice revealed improvements in mitochondrial function and increased protein turnover via ubiquitination, especially for mitochondrial and structural myofibrillar proteins. Mass spectrometry-based metabolomics revealed alterations in energy metabolism and fatty acid oxidation. These findings challenge the traditional assumptions regarding hemolytic risk during exercise in G6PD deficiency, suggesting a potential metabolic advantage in exercise performance for individuals carrying noncanonical G6PD variants.

The Effect of the Acid-Base Imbalance on the Shape and Structure of Red Blood Cells.

Red blood cells respond to fluctuations in blood plasma pH by changing the rate of biochemical and physical processes that affect the specific functions of individual cells. This study aimed to analyze the effect of pH changes on red blood cell morphology and structure. The findings revealed that an increase or decrease in pH above or below the physiological level of pH 7.4 results in the transformation of discocytes into echinocytes and causes significant alterations in the membrane, including its roughness, cytoskeleton structure, and the cell's elastic modulus. Furthermore, the study shown a strong connection between critical acidosis and alkalosis with increased intracellular reactive oxygen species production.

The Correlation of Red Cell Distribution Width With Peripheral Blood Smear: A Study From a Tertiary Care Hospital in Peshawar.

Anemia is a condition characterized by a shortage of red blood cells (RBCs) and hemoglobin (Hb). A peripheral blood smear (PBS) test involves examining a blood sample to identify important abnormalities in the red blood cells, white blood cells (WBC), and platelets. The aim of this study was to correlate the red cell distribution width (RDW) with peripheral blood smear findings in anemic patients presenting to a tertiary care hospital in Peshawar. This cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, from January 15, 2023, to July 14, 2023. A total of 450 patients aged 18 years and above with confirmed or suspected anemia (Hb of <13 g/dL in men and <12 g/dL in women), hemolytic disorders, or conditions affecting RBC morphology were included. Peripheral blood smear analysis was performed by two independent hematologists to minimize observer bias. Spearman's rank correlation coefficient was applied to determine the correlation between red cell distribution width and the morphological findings on the peripheral blood smear. Among 450 anemic patients, 232 (51.6%) were women, and 218 (48.4%) were men. The mean age was 25.72 ± 23.23 years. RBC indices showed microcytic RBCs in 270 (60.0%) patients, normocytic RBCs in 157 (34.9%), and macrocytic RBCs in 23 (5.1%). Hypochromic RBCs were found in 301 (66.9%) cases and normochromic in 109 (24.2%). Peripheral blood smear analysis revealed polychromasia in 37 (8.2%) patients and hypochromia in 247 (54.9%). Statistically significant correlations were observed between red cell distribution width and most PBS findings. Microcytic hypochromic anemia was the most prevalent type on the peripheral blood smear, showing a significant correlation with red cell distribution width. The strong correlation between RDW and anisocytosis suggests the potential utility of RDW as a screening tool in clinical practice.

Assessing CellaVision peripheral blood and advanced RBC application software's impact on hematologic morphology reporting: Real-world implementation experience in a large Veterans Affairs hospital.

This quality improvement study, conducted at the Kansas City Veterans Affairs Medical Center in Kansas City, Missouri, examined the change in patient reporting after transitioning from manual to CellaVision software-guided differentials and slide reviews. The primary focus was blasts and schistocytes, given their clinical significance. Three months of manual and CellaVision patient data were examined between May 2022 and February 2023. Blast and schistocyte patients were standardized to the total specimens performed and compared using 2-sample proportion testing. Other red blood cell (RBC) morphologies were also compared using this statistical analysis. Blast and schistocyte reporting after technologist review statistically increased after implementing the CellaVision software. This finding was most prevalent for low-percentage blasts. In addition, both morphologies experienced varying degrees of false-positive reporting, with 33% for low-percentage blasts and 91.7% for schistocytes. Other RBC morphologies displayed different levels of change, which could be clinically significant. The CellaVision software's increased sensitivity to blasts and schistocytes may benefit patient care, especially those with hematologic disorders. The software's high false-positive rate can be reduced by implementing quality metrics that prioritize clinically significant cells. This can be accomplished by implementing a CellaVision Champion to monitor reporting changes, perform patient lookbacks through the software, and provide technologist education. In addition, adopting a more stringent grading scale for schistocytes could also improve the high false-positive rate. Overall, CellaVision provides the ability to enhance hematology quality metrics by providing access to how patient cells are categorized and offering prompt education.

Anaemia and selected micronutrient deficiencies among young women in rural North India - A community-based study.

Anaemia is a major problem which affects half of young Indian women, impacting their health, education, and offspring. Despite ongoing efforts, a comprehensive understanding of anaemia remains limited. This study aims to assess the prevalence of anaemia among young women in rural Haryana and explore its causes comprehensively, which would help in tailoring targeted interventions for anaemia at a primary health care level. Young, non-pregnant women aged 15-24 years (n = 422) were assessed for socio-demographic details, menstrual/diet history, and anthropometry. Dietary diversity was assessed using Minimum Dietary Diversity for Women scale. Venous haemoglobin (Hb) was estimated using an auto-analyser. Serum ferritin, folate, and vitamin B12 were assessed for 260 participants. Anaemia was classified based on micronutrient deficiency. The morphology of anaemia was classified based on Red Blood Cell (RBC) indices. Multivariable analysis examined associations of anaemia with socio-demographic and clinical variables. The prevalence of anaemia was 60.7%. Among those participants tested for micronutrient deficiency (n = 260), 170 (65.4%), 48 (18.5%), and 124 (47.7%) participants had deficiency of ferritin, folate, and vitamin B12, respectively. Iron deficiency anaemia (39.1%) and dimorphic anaemia (38.5%) were the two most common types of anaemia. The mixed morphology of RBCs was the most common morphology (41.8%). Almost all participants (98.2%) had inadequate dietary diversity. Being overweight was associated with lesser odds of having anaemia [OR = 0.41; 95% CI: 0.24 - 0.71 (P = 0.01)]. The high magnitude of anaemia is high, and there is a need for nutrition-based interventions for anaemia at a primary health care level among young women in rural India.

Ematuria e proteinuria

Proteinuria and haematuria are common findings in children. However, they are indicative of a renal or urinary condition only in a minority of cases. The probability of an underlying disease causing haematuria and /or proteinuria increases when they are associated and in the presence of symptoms that suggest kidney damage, such as oedema, hypertension, or kidney failure. Transient and orthostatic proteinurias are benign conditions that do not require further investigations. Proteinuria should always be investigated when constant or heavy. If patients present with nephrotic syndrome, oedema and hypoalbuminemia, proteinuria is always pathologic. Tubular proteinuria should always be ruled out, in particular in male subjects with persistent proteinuria. Haematuria can be glomerular or non-glomerular and may present as gross haematuria or can only be detected microscopically. Macroscopic haematuria should always be investigated as it may be associated with benign conditions (fever, exertion, dehydration, nutcracker syndrome), but also with several conditions such as glomerular diseases or urolithiasis. The urine colour, the urinary sediment, the morphology of red blood cells, kidney function, the presence of proteinuria and the medical history help in the differential diagnosis. On the other hand, microscopic haematuria should be investigated only when persistent or if there is a positive family history. This paper presents 5 illustrative cases to highlight the above points.