Red Cell Distribution Width Index Research Articles

The prognostic value of red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in radiotherapy for oropharyngeal cancer.

BackgroundRed cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are known inflammatory indices. Elevated values are found in many cancers and may be associated with a poor prognosis. The article aimed to assess the impact of RDW, NLR, and PLR on overall survival (OS) of patients with oropharyngeal cancer treated with radiotherapy (RT).Materials and methodsThis retrospective study includes 208 patients treated for oropharyngeal cancer with definitive RT or RT combined with neoadjuvant or concurrent systemic therapy, at one institution between 2004 and 2014. The receiver operating characteristic (ROC) method, log-rank testing, and Cox proportional hazards regression model were used for the analysis.ResultsThe OS was significantly higher in RDW ≤ 13.8% (p = 0.001) and NLR ≤ 2.099 (p = 0.016) groups. The RDW index was characterized by the highest discriminatory ability [area under the curve (AUC) = 0.59, 95% confidence interval (CI): 0.51–0.67], closely followed by NLR (AUC = 0.58, 95% CI: 0.50–0.65). In the univariate Cox regression analysis, RDW [hazard ratio (HR): 1.28, 95% CI: 1.12–1.47, p < 0.001] and NLR (HR: 1.11, 95% CI: 1.06–1.18, p < 0.001) were associated with an increased risk of death. In the multivariate analysis, among the analyzed indices, only NLR was significantly associated with survival (HR: 1.16, 95% CI: 1.03–1.29, p = 0.012).ConclusionsIn the study, only NLR proved to be an independent predictor of OS. However, its clinical value is limited due to the relatively low sensitivity and specificity.

Red Cell Distribution Width: Commonly Performed Test Predicts Mortality in Primary Total Joint Arthroplasty.

Mortality after total joint arthroplasty (TJA) has been thoroughly explored. Short and long-term mortality appear to be correlated with patient comorbidities. Red Cell Distribution Width (RDW) is a commonly performed test that reflects the variation in red blood cell size. This study investigated the utility of RDW, when combined with comorbidity indices, in predicting mortality after TJA. Using a single institutional database, 30,437 primary TJA were identified. Patient demographics (age, gender, body mass index (BMI), pre-operative hemoglobin, RDW, and Charlson Comorbidity Index(CCI)) were queried. The primary outcome was 1-year mortality after TJA. Anemia was defined as hemoglobin <12g/dL for women and <13 g/dL for men. The normal range for RDW is 11.5-14.5%. A preliminary analysis assessed the bivariate association between demographics, preoperative anemia, RDW, CCI, and all-cause mortality within 1-year after TJA. A multivariate regression model was conducted to determine independent predictors of 1-year mortality. Finally, ROC curves were used to compare AUC of RDW, CCI and the combination of both in predicting 1-year mortality. The mean RDW was 13.6% ± 1.2. Eighteen percent of patients had pre-operative anemia. The mean CCI was 0.4 ± 0.9. RDW, anemia, CCI, and age were significantly associated with a higher incidence of 1-year mortality. RDW, CCI, age, and male sex were found to be independent risk factors for 1-year mortality. RDW (AUC= 0.68) was a better predictor of mortality compared to CCI (AUC= 0.66). The combination of RDW and CCI (AUC= 0.76) predicted 1-year mortality more accurately than CCI or RDW alone. RDW appears to be a useful parameter that, when combined with CCI, can predict the risk for 1-year mortality after TJA.

Red blood cell distribution width as a biomarker of chronic heart failure severity in elderly patients

Introduction. Chronic heart failure (CHF) is recognized as one of the most severe cardiovascular diseases with a high mortality rate. Early identification of patients at risk of poor outcomes is critical to optimize treatment.Aim: to conduct comparative analysis of laboratory markers, including the erythrocyte heterogeneity index (RDW) in CHF patients of different functional classes (f.cl.) according to ICD-10 codes.Materials and methods. A retrospective cross-sectional study with an analysis of the electronic laboratory register (JanuaryDecember 2016). 8056 patients who underwent a clinical blood test and added CRP parameters were included. The determination of the patient’s belonging to CHF wascarried out according to the ICD-10 code indicated in the direction for analysis. Identification of CHF patients by f.cl. (NYHA) was carried out according to the ICD-10 codes: code I25.2 (Postponed myocardial infarction) – 1 f. cl.; code I11.0 (Hypertensive disease with predominant heart damage with heart failure) – 2–3 f.cl .; code I50.0 (Congestive heart failure) – 4 f.cl.Results. The proportion of patients with diseases of the circulatory system (code I) was 33.4% (n = 2686), of which 403 CHF patients were selected for the study. Distribution by f.cl. according to the code MKB-10: 1 ph.cl. – 0.83% (n = 67); 2–3 f.c. – 3.84% (n = 309); 4 ph.cl. – 0.33% (n = 27). Significant intergroup differences were obtained between ph.cl. (according to Kruskal–Wallis) for indicators: hemoglobin (H = 9.741111, p = 0.0077), erythrocytes (H = 7.176770, p = 0.0276), RDW indicator (H = 34.78287, p = 0.0000). There were no statistically significant differences in leukocytes, platelets, ESR, CRP.Conclusions. The presence of anemia in groups of patients with CHF of different f.cl., which often accompanies the disease, has not been confirmed. But statistically significant differences were revealed depending on the severity of f.cl. CHF according to the level of hemoglobin, the number of erythrocytes, and highly significant - according to the RDW indicator. The latter allows us to discuss the role of the RDW index as a possible new laboratory biomarker of CHF severity available for routine clinical practice.

Red cell distribution width as a differential parameter between iron deficiency anemia and a-thalassemia: an empirical approach

Iron deficiency anemia (IDA) and thalassemia minor are the most common hypochromic microcytic anemias in the world. Different formulas have been proposed to differentiate IDA from beta thalassemia minor. However, yet no formula has been proposed to differentiate IDA from alpha thalassemia minor, and Hb electrophoresis is not helpful in this hemoglobinopathy. Red cell distribution width (RDW) as indicator of changes in red blood cell size is primarily employed to differentiate IDA from other microcytic anemias. An empirical approach involving iron therapy over 1 month has shown that an increase in Hb concentration by 1 g/dL over this period is indicative of IDA, while no changes in Hb concentration are suggestive of alpha thalassemia. RDW measured after iron therapy in order to differentiate IDA and related disorders from alpha thalassemia is a better index than an increased reticulocyte count. Due to the high prevalence of IDA and costly and time-consuming nature of specific diagnostic tests, the RDW index is considered as a very sensitive and cost-effective tool in the differential diagnosis of IDA.

DIAGNOSTIC EFFICACY OF RED BLOOD CELL INDICES IN DIAGNOSIS OF BETA THALASSEMIA TRAIT TAKING HAEMOGLOBIN ELECTROPHORESIS AS GOLD STANDARD

Objective: To determine the diagnostic efficacy of haematological indices for the diagnosis of beta thalassemia trait taking haemoglobin electrophoresis as a gold standard.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Department of Haematology Combined Military Hospital Lahore, from Aug to Dec 2019.&#x0D; Methodology: Two hundred and six anaemic patients 20-70 years of age of both genders were included in the study. Blood was collected from all the patients and complete blood count were generated through automated haematology analyser Sysmex KX-21. Based on the complete blood count parameters like mean cell volume, red blood cell count, red cell distribution width and mean cell haemoglobinthe haematological indices such as Mentzer, Ricerca, mean density of Hb/litre of blood, mean cell Hb density and red cell distributon width indices were calculated. The haemoglobin A2 band of &gt;3.5% on haemoglobin electrophoresis was taken as cut off for Beta thalassemia trait.&#x0D; Results: Out of the 206 blood samples analysed, 120 (58%) were labelled as Beta thalassemia trait after Hb electrophoresis and 86 cases had anemia due to other causes. Mentzer index established the highest sensitivity of 92.5% whereas RICERCA index established the highest specificity of 94.1%. Mentzer and red cell distribution width indexhad highest diagnostic efficacy value up to 90.3%.&#x0D; Conclusion: We conclude that Mentzer and red cell distribution width index showed the highest diagnostic significance. The Mentzer index has the highest sensitivity whereas Ricerca index has the highest specificity. The red blood cell count, haemoglobin and mean cell volume.............

Markers predicting critical illness and mortality in COVID-19 patients: A multi-centre retrospective study

Aim: In this study, we aimed to investigate early predictors of critical illness and mortality in patients with coronavirus disease 2019 (COVID-19) based on clinical, biochemical, radiological, and epidemiological findings. Materials and Methods: This multi-center, retrospective study was conducted in three centers and included a total of 206 confirmed COVID-19 cases using reverse transcription-polymerase chain reaction (RT-PCR). Data of survivors and non-survivors were compared, and predictors of mortality were examined. Results: Among the patients, 103 (50%) were males with a mean age of 52.8±16.7 years;88.3% of the patients were discharged in a healthy condition, while 11.7% died. The mean age was significantly higher in non-survivors. Dyspnea occurred in 32.5% of patients, and a significant correlation was found between dyspnea and mortality (p<0.001). Thoracic computed tomography (CT) findings were positive in 88.8% of patients. The most frequent imaging findings were ground-glass opacities in 86.4% and consolidation in 33% of patients. The mortality rate was significantly higher in patients with comorbidities (p<0.001). There was also a significant correlation between lymphocytopenia and mortality (p<0.001). A positive correlation was found between mortality risk and platelet-to-lymphocyte, neutrophil-to-lymphocyte, and red cell distribution width indices. The mortality risk was significantly higher in patients with acute kidney injury (10.7%) (p<0.001). Discussion: These results suggest that advanced age, coexisting diabetes, hypertension, heart failure, chronic kidney disease, or acute kidney injury are associated with an increased mortality risk. The presence of dyspnoea or consolidation on thoracic CT can predict an increased mortality risk in COVID-19 patients.

Erythropoiesis changes with increasing age in the elderly Chinese

Erythropoiesis slowly decreases with increasing age, which may be reflected in red blood cell (RBC) parameters. This multicentre collaborative study aimed to investigate the changes in erythropoiesis with increasing age in a healthy Chinese population. A total of 14,591 healthy individuals (6,713 aged at least 60y and 7,878 aged below 60y) from seven cities across China were enrolled. K2-EDTA anticoagulant blood samples were analysed. The results are presented as median and 2.5-97.5th percentile. RBC parameters showed some differences between the two groups divided by the age of 60 in the Chinese population. The median, 2.5th and 97.5th percentile values of RBC, haemoglobin (HGB) and haematocrit (HCT) in patients aged ≥60y were significantly lower than in those ˂60y. The values of mean cell volume (MCV), mean cell haemoglobin (MCH) and red cell distribution width (RDW) were higher in the group aged ≥60y. Men had significantly higher RBC, HGB, HCT, MCV, MCH and RDW indices than women. The prevalence of anaemia gradually increased with age in men and was higher than that in women after 50. The median haemoglobin and MCV in Nanning and Guangzhou were lower than those in other regions. RBC parameters varied with increasing age and differed between males and females, indicating that erythropoiesis decreases in the elderly Chinese population. Subsequent studies should be conducted for age- and sex-specific reference intervals in healthy elderly Chinese populations.

Effects of salinity stress on seedling biomass, physiochemical properties, and grain yield in different breeding wheat genotypes

The salinity tolerance of 17 breeding wheat genotypes along with three local varieties was evaluated under control and salinity stress (160 mM NaCl) conditions. At the seedling stage, several growth and physiological traits were measured. Moreover, the investigated genotypes were assessed in terms of grain yield across four saline regions during the 2018–2019 cropping seasons. Salinity treatment significantly decreased in the root and shoot dry weights (RDW and SDW), photosynthesis rate (PN), stomatal conductance (GS), transpiration rate (TE), shoot K+ content (SK), root K+/Na+ (RKN), shoot K+/Na+ (SKN), root-to-shoot Na+ translocation (RTSN), and root-to-shoot K+ translocation (RTSK), but resulted in increased root Na+ content (RN), root K+ content (RK), and shoot Na+ content (SN). The results of additive main effects and multiplicative interaction analysis (AMMI) also indicated significant differences among test environments (E), genotypes (G), and their interaction effects (GEI). The PCA-based biplot revealed that grain yield strongly correlated with RKN and RK. Furthermore, the correlation among PN, GS, and TE traits was strong and positive and had a positive correlation with RWC, MSI, RDW, and SPAD index. Considering our results, RK and RKN were identified as useful physiological tools to screen salt tolerance at the early-growth stage. According to the ranking patterns obtained by the average sum of ranks method (ASR) and grain yield, we observed that genotype number G5 had considerable physiological potential at the early-growth stage and also responded well to soil salinity at the farm; thus, this genotype can be promoted for commercial production.

EVALUATION OF DIAGNOSTIC ACCURACY OF HEMATOLOGICAL INDICES IN THE DIFFERENTIATION OF BETA THALASSEMIA TRAIT FROM IRON DEFICIENCY ANEMIA

Background: 2 most frequent type of microcytic hypochromic anemias are Iron deciency anemia (IDA) and beta thalassemia trait (β-TT) continue to be a cause of signicant burden to the society, particularly in developing countries like INDIA, where there is limitation of resources. The objective of the present study was to evaluate the validity of different discrimination indices to differentiate β-TTfromIDA. Methods:All diagnosed patients of microcytic hypochromic anemia admitted in Geetanjali Medical College and Hospital, Udaipur (Raj) between Jan 2018 to June 2020, were included in this study. Sensitivity, specicity, positive predictive value (PPV), negative predictive value (NPV) and Youden's index (YI) were calculated. Result: According to our study following rankings of various discrimination indices were obtained for BTT patients, RDW Index &gt; Mentzer's Index = Ehsani Index &gt; Sirdah Index &gt; MDHLIndex &gt; MCHD Index. Conclusion: According to our results and observations, the percentage of correctly diagnosed patients are the highest with RDW Index and Mentzer's Index. It should be kept in mind that several studies have shown that none of the red cell indices carry 100% sensitivity and specicity in diagnosing BTT.

The value of the red cell distribution width index versus other parameters in the differentiation between iron deficiency anemia and beta thalassemia trait among children in Mosul, Iraq

ABSTRACT Background Iron deficiency anemia (IDA) in children may be confounded with the beta-thalassemia trait (BTT). This study aimed to reevaluate the role of the red blood cell distribution width index (RDWI) in distinguishing BTT from IDA. Research design and methods This cross-sectional study was conducted from June 2018 to February 2019 in two pediatric teaching hospitals in Mosul, Iraq. Two sets of patients with hypochromic microcytic anemia in the age range 6 months-12 years were included. The receiver-operating characteristics curve was used to identify the test best distinguishing BTT from IDA. Results In the first patient set, 54 (51.92%) had IDA and 50 (48.07%) had BTT. The area under the curve (AUC) for the RDWI was larger than for other parameters at 0.963, suggesting a discriminant tool to detect cases of BTT (p-value < 0.0001) . In the second patient set, 25 (42.85%) IDA cases and 20 (57.14%) BTT cases were analyzed, and the RDWI still had the highest AUC when compared with other parameters (p-value < 0.0001). An RDWI cutoff value suggested to differentiate BTT from IDA was 200.18 and 200.35 respectively for both groups. Conclusions RDWI may be a useful screening parameter in differentiating BTT from IDA.

Complete hemogram: simple and cost-effective in staging and predicting outcome in acute pancreatitis.

An important goal in management of acute pancreatitis (AP) is early prediction and recognition of disease severity. Various predictive scoring systems are in clinical use with their own limitations and there is always a quest for simple, practical, quantifiable, dynamic and readily available markers for predicting disease severity and outcome. Complete hemogram is routinely ordered in all patients with AP. In recent years red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet lymphocyte ratio (PLR) have been found to be independent predictors of prognosis in various benign and malignant conditions. This prospective study evaluated complete hemogram based markers in AP. Complete hemogram analysis was done and NLR, LMR, PLR values were calculated. Development of organ failure, the need for intensive care unit (ICU) admission and interventions, development of complications (local/systemic) and 100-day mortality were assessed. In this study 160 subjects of AP were included. Complete hemogram analysis was performed within 24 h after admission. C‑reactive protein, RDW, NLR, PLR and bedside index of severity in acute pancreatitis (BISAP) values were higher in severe AP than moderate AP group than mild AP group, while LMR values were decreased in the corresponding severe, moderate and mild AP groups (p < 0.001). The NLR performed best for prediction of ICU admission, organ failure, interventions and mortality with area under receiver operating curve (AUROC) were 0.943, 0.940, 0.902 and 0.910, respectively. Hemogram based markers are simple, objective, dynamic and readily available. They can be considered in addition to conventional multifactorial scoring systems for prediction of outcome and prognosis of AP.

UTILITY OF BLOOD INDICES AND PARAMETERS FOR DIFFERENTIATING IRON DEFICIENCY ANAEMIA AND β-THALASSEMIA TRAIT BY CALCULATING VARIOUS DISCRIMINANT FUNCTIONS

The most commonly encountered disorders with microcytic anemia are iron deficiency anemia (IDA) and β-thalassemia trait (BTT).It is important to distinguish between IDA and BTT to avoid unnecessary iron therapy and the development of hemosiderosis.Various parameters obtained on automated haematology analyser by calculating discriminant functions have been helpful to differentiate iron deficiency anemia and β-thalassemia trait. Materials and Methods: This study was carried out in the pathology department of Gujarat Adani Institute Of Medical Science.We had studied 100 cases of differentiating Iron deficiency anaemia and β-Thalassaemia trait from patient's case records and laboratory reports irrespective of age and sex over a period of one year (January 2020 to December 2020).Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin (Hb). All the selected subjects' samples were subjected to blood morphology, comparison of mean cell volume (MCV), RBC count, red cell distribution width (RDW), Red cell distribution width Index (RDWI),Srivastav Index(SI),Green and king Index (GI) and Mentzer's Index(MI). Results: Out of 100 cases seventy five were diagnosed having iron deficiency anaemia, whereas twenty five were having βthalassemia trait. The RBC count was higher and MCV was much lower in β-thalassemia trait as compared to iron deficiency anaemia.Both groups were subjected to RDW,RDWI,SI,MI and GI. Conclusion:Among various discriminant function calculated from different haematological parameters and blood indices,Mentzer index and Srivasta index are more sensitive and specific for differentiating iron deficiency anaemia and β-thalassemia trait.

Background: Iron Deficiency Anemia (IDA) and beta-thalassemia trait (&amp;beta;-TT) are the two most prevalent causes of microcytic hypochromic anemia. The current study aimed to assess the accuracy of the various indices to distinguish these two conditions. Material &amp;amp; Methods: A total of 40 patients were studied retrospectively by calculating six discrimination indices. The patients were assessed according to the Mentzer,

Background Iron Deficiency Anemia IDA and beta-thalassemia trait beta-TT are the two most prevalent causes of microcytic hypochromic anemia. The current study aimed to assess the accuracy of the various indices to distinguish these two conditions.Material amp Methods A total of 40 patients were studied retrospectively by calculating six discrimination indices. The patients were assessed according to the Mentzer Shine amp Lal England amp Fraser Green amp King Red Cell Distribution Width Index RDWI and Srivastava indices. The study included 19 beta-TT cases based on low Hb and mean cell volume MCV levels normal serum iron and raised levels of HbA2 gt3.5 and 21 IDA cases with low hemoglobin low serum iron low ferritin high total iron-binding capacity and normal electrophoresis. The accurately diagnosed cases were identified and their sensitivity specificity positive and negative predictive value and Youdenrsquos index of the indices were calculated.Results None of the indices showed a sensitivity and specificity of 100. The percentage correctly diagnosed was highest for RDWI 97.5 followed by Green and King 95. Youdenrsquos index was also highest for RDWI 95 followed by Green and King 90 and Mentzer 84.7.Conclusion RDWI Green amp King and Mentzer are readily available and the most stable indices in differentiating between IDA and beta-TT.

Evaluation of Beta Globin Gene Mutations in Beta Thalassemia Carrier Children in Aydın Province and its Environment

Objective: Beta thalassemia carriers (BTC) in Turkey is observed with a frequency of 2.1%, and it is the most common cause of anemia after iron deficiency. There are few studies showing the effect of genotype on phenotype in beta thalassemia carrying children. The aim of this study is to determine the mutation diversity of these children in and around Aydın and evaluate the effects of these mutations on complete blood count parameters and hemoglobin electrophoresis. Methods: This study included mutation analysis of 65 patients who were diagnosed as BTC in Adnan Menderes University, Faculty of Medicine, Department of Child Health and Diseases, Pediatric Hematology Outpatient Clinic between 01.01.2014 and 01.08.2019. Complete blood count, hemoglobin electrophoresis and mutation analysis results were obtained from the computer data system and patient files. Research data were evaluated by using SPSS 21.0 statistics program. Results: 39 (60.0%) of the sixty-five patients were male, 26 (40.0%) were female, and the mean age was 8.34±4.94 years. When full blood count parameters were analyzed, 87.7% had anemia, 100% microcytosis and high red cell distribution width (RDW) level, 49.2% hypochromia and 87.7% high red blood cell (RBC) count. RDW level was ≥16 in 66.2% of the cases. Seventeen different mutations were detected. The mutations most frequently occurred in “intron 1” gene region (66.1%). The most common ones were IVS I-110 (44.11%), IVS I-1 G&gt;A Heterozygotes (8.8%,) IVS I-6 T&gt;C Heterozygotes (7.5%) and IVS II-745 (7.5%). RDW level was ≥16 in 66.2% of the cases. Seventeen different mutations were detected. The mutations most frequently occurred in “intron 1” (66.1%) gene region. IVS I-110 (44.11%), IVS I-1 G&gt;A Heterozygotes (8.8%,) IVS I-6 T&gt;C Heterozygotes (7.5%) and IVS II-745 (7.5%) were observed most commonly. In patients with IVS I-110 mutation, mean Hb level was 10.55 gr/dL, MCV level was 58.44 fL, RDW level was 16.51, RBC level was 5680x10⁹/L, HbA2 level was 4.77%, HbF level was 2.34%. Mutations detected in 12 patients with HbF level above 5% were as IVS I-110 (5 people), IVS I-6 T&gt;C Heterozygotes, Codon 39 C&gt;T Heterozygotes, IVS I-116, c.25-26 del AA (plys9Valfs) Heterozygotes, c.27dupG (pSer10valfs*14), c316-373 (IVSII-478 C&gt;A Heterozygotes), -87 C&gt;T Heterozygotes. Mentzer index was calculated as &gt;13 in six patients (9.2%). The mutations seen in these patients were IVS-I 110, c.27dupG (p.Ser10valfs*14), c316-373 (IVS II-478 C&gt;A Heterozygotes), -87 C&gt;T Heterozygotes. There were four patients (6.1%) with a RDW index &gt;220. Two of these patients had c.27dupG (p.Ser10valfs*14) and others had c316-373 (IVS II-478 C&gt;A Heterozygotes) and -87 C&gt;T Heterozygotes mutations. Mutations detected in four patients with HbF levels in the range of 9.48-15.67 were IVS I-116 T&gt;G Heterozygotes, IVS I-110 G&gt;A Heterozygotes, c.25-26 del AA (p.lys59valfs) Heterozygotes, c27 dupG (pSer10 valfs*14) and three of these mutations carrying β° mutation type were located in exon 1 and one of them carrying β⁺ mutation type (IVS I-110) was in intron 1. Conclusion: The same mutations detected in patients with beta thalassemia carriers have different effects on complete blood count parameters. HbA2 and HbF levels suggest that these mutations are not effective on the phenotype alone and there may be additional factors which should be clarified. We think that there may be BTC in cases with low RBC, Mentzer index ≥13 and RDW index ≥220, HbA2 &lt;3.5 and studying the mutation analysis of these patients will contribute significantly to the literature.

Difference of Het Re Level In Thalassemia β Minor And Iron Deficiency Anemia

The population was students who were admitted to the University of Dr. Soetomo who came for complete blood count examination. The subjects were students with MCV &lt;80 fl, MCH &lt;27 pq. Subjects who met the inclusion criteria then continued with the calculation of the Mentzer Index and RDW Index, ferritin serum examination using the ECLIA method, hemoglobin electrophoresis examination with micro capillary electrophoresis. By consecutive sampling, 42 samples were obtained, of which 21 subjects diagnosed with iron deficiency anemia and 21 subjects diagnosed with beta thalassemia minor were examined for their Ret-He levels using the flowsitometric method which were then analyzed statistically.From the results of the study concluded that there was a significant difference between the levels of Ret-He in patients with iron deficiency anemia with thalassemia beta minor patients with a cut-off value of 27.30pg

Prevalence Of Suspected Beta Thalassemia Minor Based On Screening With Mentzer Index And Red Distribtion Width In Students Of Smp Negeri 7 Pujut

Background : Beta thalassemia is blood disorder that it often found in Indonesia with high frequency of beta thalassemia carrier genes around 3 to 10%. Thalassemia has not been cured, but can be prevented by screening of thalassemia to identify individuals with beta minor thalassemia in population. The purpose of this study was to determine prevalence of anemia and prevalence of suspected beta thalassemia minor in students of SMP Negeri 7 Pujut based on Mentzer index and Red Distribution Width index.&#x0D; Methode: This study was an quantitative descriptive design with cross sectional approach. Total number of 130 students of SMP Negeri 7 Pujut were recruited with proportional random sampling stratified technique. Screening of beta thalassemia minor by calculating erythrocyte index of anemia blood samples using Mentzer index and Red Distribution Width index. Mentzer index was calculated by dividing Mean Corpuscular Volume (MCV) by Red Blood Count (RBC). RDW index was calculated by by multiplying MCV by RDW and divided by RBC.&#x0D; Result: According to data analysis, prevalence of anemia in students was 16.9% based on Hb concentrations for diagnosis anaemia based on WHO. Prevalence of suspected beta thalassemia minor was 0% based on Mentzer index and 4,6% based on RDW index.&#x0D; Conclusion: Prevalence of anemia in students was 16.9% based on Hb concentrations for diagnosis of anaemia WHO and prevalence of suspected beta thalassemia minor was 4,6% based on RDW index.

Role of Red Cell Distribution Width Index for Differentiation of Iron Deficiency Anaemia and Beta Thalassemia Trait

Role of Red Cell Distribution Width Index for Differentiation of Iron Deficiency Anaemia and Beta Thalassemia Trait

DIFFERENCE OF HET RE LEVEL IN THALASSEMIA Β MINOR AND IRON DEFICIENCY ANEMIA

Background The most common diseases found with peripheral blood morphological features of hypochromic microcytic anemia are iron deficiency anemia and thalassemia. Hypochrome micrositer is a morphological description of red blood cells with MCV values smaller than normal (&lt;80fl) and MCH smaller than normal values (&lt;27pq). This morphological picture can be found in the condition of iron deficiency anemia and thalassemia. There are several markers for the assessment of Hb content in reticulocytes, including Ret-He. Ret-He, which can be measured by the latest automated hematological analysis, is considered to reflect the iron content in reticulocytes Aim Using Ret-He levels as a marker in distinguishing patients with β minor thalassemia and iron deficiency anemia. Method This research is an observational analytic study using case control measurement method, during April to July 2019 at the Department of Clinical Pathology, Faculty of Medicine, University of North Sumatra / H. Adam Malik General Hospital Medan. The population was students who were admitted to the University of North Sumatra who came for complete blood count examination. The subjects were students with MCV &lt;80 fl, MCH &lt;27 pq. Subjects who met the inclusion criteria then continued with the calculation of the Mentzer Index and RDW Index, ferritin serum examination using the ECLIA method, hemoglobin electrophoresis examination with micro capillary electrophoresis. By consecutive sampling, 42 samples were obtained, of which 21 subjects diagnosed with iron deficiency anemia and 21 subjects diagnosed with beta thalassemia minor were examined for their Ret-He levels using the flowsitometric method which were then analyzed statistically. Results From 21 iron deficiency anemia patients it was found that the average Ret-He value was 30.64 (6.08) pg and from 21 patients with beta minor thalassemia it was found that the average Ret-He value was 25.63 (6 , 72) pg. The results of the unpaired t-test for both groups obtained p = 0.016. By using the ROC curve obtained the Ret-He cut-off value in distinguishing cases of iron deficiency anemia with thalassemia was 27.30 pg with a sensitivity of 90.5% and specificity of 71.4%. Conclusion From the results of the study concluded that there was a significant difference between the levels of Ret-He in patients with iron deficiency anemia with thalassemia beta minor patients with a cut-off value of 27.30pg

Red Cell Distribution Width (RDW) Index as a Predictor of Severity of Acute Ischemic Stroke: A Correlation Study.

Introduction:Globally, stroke is one of the leading causes of death and disability-adjusted life-years (DALYs). The red cell distribution width (RDW) is a readily available and inexpensive test which is done routinely as a part of complete blood count in these patients.Objective:In this study, we tried to correlate the RDW with severity of acute ischemic stroke (AIS).Methods:Patients presenting to emergency department (ED) within 24 hours of the onset of clinical signs and symptoms suggestive of AIS were assessed for Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) score followed by non-contrast computed tomography (NCCT) scan. RDW value for all the patients who were included in the study were co-related with the severity of the stroke.Results:The median (IQR) RDW in the patients with minor stroke on the basis of GCS was 13.5 (13.3–13.5), moderate stroke was 13.8 (13.5–14.4) and with severe stroke was 15.4 (15.1–15.6) (p < 0.001). The median (IQR) RDW in the patients with minor stroke on the basis of NIHSS score was 13.4 (13.2 – 13.6), moderate stroke was 13.8 (13.5–14.3), and moderate to severe stroke was 14.7 (14.5–15.3) and with severe stroke was 15.5 (15.1–15.7) (p < 0.001). The median RDW in patients who were alive was 13.8 (13.5–15.1) and in patients who expired was 15.5 (14.5–15.7) (p = 0.048).Conclusion:Based on the findings of this study, RDW index has statistically significant correlation with the severity of AIS. So it can potentially be an important parameter to predict the prognosis of AIS patients.

Analysis of the functional state of red blood cells in patients with surgical pathology of the aorta after surgical intervention using cardiopulmonary bypass (cogortant prospective research)

The aim is to analyse the functional state of red blood cells in patients with surgical pathology of the aorta after surgical intervention using cardiopulmonary bypass.Materials and Methods. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate (esophosphine). Erythrocyte indices were analyzed: MCV (mean erythrocyte volume), MCH (mean hemoglobin in erythrocyte), MCHC (mean hemoglobin concentration in erythrocyte mass) and RDW (erythrocyte mean volume ratio).Result. When analyzing the dynamics of the indicator of the width of the distribution of erythrocytes by volume (coefficient of the average volume of the erythrocyte) in the blood of patients with groups K, I and II, no significant differences were found between the groups. Despite the absence of statistically significant differences in the RDW index between the groups on a daily basis and in comparison with the starting values, nevertheless, in patients of group II, the recovery of its numbers was faster compared to others. Considering that patients of group II differed in prescribing an additional substance to the main treatment protocol - D-fructose-1,6-diphosphate sodium hydrate salt - its pharmacodynamic effect can be considered positive for the erythrocyte membrane elasticity, their elasticity and hemolytic resistance.Conclusions. It can be argued that the mere fact of anesthesia support using cardiopulmonary bypass negatively affects the state of erythrocyte indices: МСV, МСН, МСНС, RDW. The study provides a vector for the appointment during surgery additional pharmacological substances that would have a positive impact on these indicators