Red Cell Indices Research Articles

Case report: Suspected propofol associated Heinz body anemia in five mechanically ventilated dogs: a historical case series

ObjectiveThe aim of this report is to raise awareness of the risk of oxidant-induced erythrocyte injury, including Heinz body (HB) anemia, in critically ill dogs by describing the condition in five dogs receiving constant rate infusions of propofol.Case summaryThis case series describes five dogs with suspected propofol-induced HB anemia undergoing mechanical ventilation (MV) for lower motor neuron disease. Four of the five dogs were treated for tick paralysis (Ixodes holocyclus) and one was treated for suspected eastern brown snake (Pseudonaja textilis) envenomation. Propofol constant rate infusions were administered as part of total intravenous anesthesia. All five dogs became anemic, and a complete blood count and blood smear interpretation by a specialist clinical pathologist confirmed the presence of oxidative red blood cell injury (eccentrocytosis and HBs). The duration of MV ranged from 76 to 131 h, with HBs identified within 47–96 h of commencing propofol. All five dogs survived to discharge, with one dog requiring a blood transfusion.DiscussionWhile propofol-induced HB anemia is a recognized phenomenon in cats, to the author’s knowledge, this is the first case series detailing multiple occurrences in dogs. Veterinarians should be aware of the risk of propofol-induced oxidative erythrocyte injury in dogs receiving prolonged infusions of propofol, and consider risk mitigation by using propofol as part of multiagent intravenous anesthesia, keeping dose rates as low as possible, and daily monitoring of blood smears and red blood cell indices.

Prevalence and Hematological Changes in Urogenital Schistosomiasis: Infection Persistence in the Phase of Mass Drug Administration in Sempoa (Kwahu East, Ghana): A Cross-Sectional Study.

Schistosomiasis is a chronic neglected tropical disease and Ghana's second most prevalent helminth infection. The annual mass drug administration of praziquantel to school children is aimed at reducing disease morbidity as a public health problem. The study aimed to assess the prevalence and hematological profile of urinary schistosomiasis in Sempoa after over a decade of consecutive Mass Drug Administration (MDA) of praziquantel. A community-based cross-sectional study involving 126 participants was conducted. Schistosoma haematobium eggs were identified and quantified using the urine filtration-microscopy technique. The hematological profile was analyzed using a fully automated 5-part Sysmex XN-350 (Sysmex Co, Germany) analyzer. The study recorded a prevalence of 21.6% that was significantly related to water contact activities. Schistosomiasis was significantly associated with lower levels of Red Blood Cell (RBC) indices; MCV (p < 0.001), MCHC (p < 0.001), and MCH (p = 0.01) with higher platelet, lymphocytes, and basophil counts compared to the uninfected. Heavy infection was significantly associated with lower hemoglobin levels. The study further reported microhaematuria as a sensitive and specific proxy diagnostic tool for field surveillance in endemic communities. Urinary schistosomiasis accompanied by an altered hematological profile persists in Sempoa under preventive praziquantel. Future control interventions must consider an integrated approach of marrying behavioral change, with preventive chemotherapy and vector control.

Association between red blood cell indices and non-alcoholic fatty liver disease: Prospective study and two-sample Mendelian randomization analysis based on large cohorts.

Non-alcoholic fatty liver disease (NAFLD) is the primary contributor to persistent chronic liver disease which derives cardiovascular disease, malignancies, and related mortality. There is an association between red blood cell (RBC) indices and the incidence of NAFLD, but the causal relationship has not been determined. We aimed to investigate the association through prospective and Mendelian randomization (MR) analyses. The prospective study involved 237,016 participants from the UK Biobank. We employed Cox proportional hazard models and restricted cubic spline models to assess the association between RBC index and NAFLD, and used two-sample MR analysis to identify any causality. Over a mean follow-up of 8.64 years, 2,894 participants from UK Biobank developed NAFLD. The prospective study showed significant associations between high levels of hemoglobin (HGB) (hazard ratio [HR], 1.41; 95% confidence intervals [CI] 1.24-1.60; P < 0.001), RBC count (HR, 1.20; 95% CI, 1.07-1.36; P=0.003) and an increased risk of NAFLD. MR analysis indicated a causal relationship between high HGB levels and NAFLD risk (Odds ratio [OR], 1.55; 95% CI, 1.11-2.18; P=0.010). However, there was no observed causal relationship between RBC count and NAFLD. This prospective and MR analysis demonstrated a positive causal relationship between HGB levels and NAFLD. HGB can predict the risk of NAFLD, which can potentially be used as a large-scale non-invasive tool to dynamically monitor the occurrence and development of NAFLD.

Alteration of Blood Parameters in Non-Dialyzed Patients of Chronic Kidney Disease

Chronic kidney disease (CKD) is a serious health problem that can lead to end-stage renal disease. Patients with CKD are usually suffered from anemia, which is one of the major consequences of kidney damage which in turn lead to reduce quality of life, increased risk of cardiovascular disease and cognitive impairment. The study aimed to assess the hematological abnormalities in the CKD patients during pre-dialyzed conditions in EL-Beyda City. The study was included 107 patients who are attended to Nephrology Department in EL-Bayda Medical Center in the period from November 2021 to March 2022. The study was included all CKD stages and were not on dialysis and they were following upped by these centers regularly each month. Data sources were obtained from the personal interview with patients and the records files in Nephrology units. Blood samples were taken in EDTA tube to measure complete blood counts (CBC) include hemoglobin (Hb), hematocrit (HCT), Mean cell volume (MCV), Mean cell hemoglobin (MCH), Mean cell hemoglobin concentration (MCHC), white blood cells (WBC) and platelets count (PLT), as well as renal function tests (blood urea and creatinine). The data were analyzed by Minitab version17. Out of 107 patients were included in this study, 63(58.8%) of patients were females and 44(41.1%) were males, The majority of patients had chronic diseases which could be the contributing cause of CKD; 62% were suffered from hypertension, 40% suffered from diabetes. Anemia was the main abnormality in our study which observed in 49 of participants (45.8%) while the others were non anemic accounting 54% (14.6±0.23). There was a significant difference in the mean of hemoglobin and hematocrit between anemic and non-anemic participants (p- value=0.000). Red cell indices showed normocytic normochromic anemia, thrombocytopenia was noticed in 7 (14%) of patients and leukocytosis was reported in 9 (18%) of them. We can conclude that developing of anemia in CKD patients is associated with poor outcomes and requires a careful management to avoid comorbidities.

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.

Molecular Characterization, Oxidative Stress-Mediated Genotoxicity, and Hemato-Biochemical Changes in Domestic Water Buffaloes Naturally Infected with Trypanosoma evansi Under Field Conditions.

(1) Background: Surra is a debilitating disease of wild and domestic animals caused by Trypanosoma evansi (T. evansi), resulting in significant mortality and production losses in the affected animals. This study is the first to assess the genetic relationships of T. evansi in naturally affected buffaloes from Multan district, Pakistan, using ITS-1 primers and evaluating the effects of parasitemia and oxidative stress on DNA damage and hematobiochemical changes in infected buffaloes. (2) Methods: Blood samples were collected from 167 buffaloes using a multi-stage cluster sampling strategy, and trypomastigote identification was performed through microscopy and PCR targeting RoTat 1.2 and ITS-1 primers. Molecular characterization involved ITS-1 via neighbor-joining analysis. The impact of parasitemia loads was correlated with oxidative stress markers, genotoxicity, and hematobiochemical parameters using Pearson correlation and multivariable regression models. (3) Results: Field-stained thin blood film microscopy and molecular identification revealed 8.98% and 10.18% infection rates, respectively. Phylogenetic analysis based on ITS-1 region sequences of the identified isolates showed close genetic associations with Indian isolates. The mean trypomastigote count observed in the infected buffaloes was 5.15 × 106 (±5.3 × 102)/µL of blood. The parasitemia loads were significantly correlated with the alterations in oxidative stress markers, DNA damage, and changes in hematobiochemical parameters. Infected animals exhibited significant (p < 0.05) alterations in oxidative stress biomarkers, including catalase, nitric oxide, and malondialdehyde concentrations. Noteworthily, a comet assay revealed a significantly (p < 0.0001) higher mean genetic damage index in the infected buffaloes (0.7 ± 0.04) compared with the healthy ones (0.196 ± 0.004). Alongside significant (p < 0.05) reductions in red cell indices, a marked elevation in leukocyte counts and serum hepatic enzyme levels was recorded in the affected buffaloes. (4) Conclusion: T. evansi isolates of buffaloes from Multan, Pakistan, have genetic similarities to Indian isolates. This study also revealed that higher parasitemia loads induce genotoxicity in the infected animals through oxidative stress and cause hematobiochemical alterations under natural field conditions.

Correlation of red blood cell parameters and platelet count among adult anemic patients attending Madda Walabu University Goba Referral Hospital, Goba, Southeast Ethiopia: A comparative cross-sectional study.

Anemia is a worldwide public health problem and is associated with platelet disorders. The relationship between anemia and platelets is complex, with the association being either normal platelet count or thrombocytosis. Platelets are significantly decreased in patients with anemia, and thrombocytopenia has been documented in patients with severe anemia. There are few reports in the literature on the correlation between platelet count and red blood cell parameters in anemic patients. Therefore, this study aimed to compare the correlation between red blood cell parameters and platelet count in adult anemic patients attending Madda Walabu University Goba Referral Hospital (MWUGRH): Goba, Southeast Ethiopia, from May 30 to July 30, 2022. A cross-sectional comparative study was conducted among 352 subjects (176 anemic and 176 controls) who attended the hospital during the study period and were recruited using a convenient sampling technique. Sociodemographic and other relevant variables were collected using a structured questionnaire. Four milliliters of venous blood were collected and placed in a K2EDTA tube for analysis of hematologic parameters using the Sysmex XN-550 (Sysmex Corp., Japan) automated hematology analyzer; the hemoglobin value was used to determine anemia status. Data were entered into Epidata Manager, version 4.6.0.2, and analyzed using SPSS Statistical Software, version 25. The independent-sample t-test was used to compare parameters between groups, and correlation statistics was used to correlate parameters between groups. Chi-square was used at a 95% confidence interval, considering P < .05 statistically significant for association among categorical variables. Correlation analysis showed that platelet count was significantly, positively correlated with RBC, and negatively correlated with MCV, MCH, and MCHC (r (P) = 0.168 (.026) and -0.252 (.000), -0.275 (.001), -0.218 (.004), respectively). It was also negatively correlated with HGB and HCT levels in the healthy control (r (P) = -0.266 (.000) and -0.149 (.049) respectively). Morphologically, 44.32% were microcytic hypochromic anemia, 53.98% were normocytic normochromic anemia and 1.70% were macrocytic anemia. The findings showed that platelet count variation correlates well with red cell indices and morphologic types of anemia in adult anemic patients. Such correlation will enable physicians to make diagnoses and administer treatments.

Associations of Essential and Non-Essential Trace Elements' Levels in the Blood, Serum, and Urine in Women with Premature Ovarian Insufficiency.

Premature ovarian insufficiency (POI) is poorly understood, with causes identified in only 25% of cases. Emerging evidence suggests links between trace elements (TEs) and POI. This study is the first to compare concentrations of manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), molybdenum (Mo), arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) across urine, serum, and whole blood in women with POI compared to healthy controls (HC), aiming to explore their distribution and potential associations with POI. This cross-sectional-case-control study enrolled 81 participants (40 POI patients and 41 healthy controls) at the University Medical Centre Ljubljana, Slovenia. Blood and urine samples were collected to quantify basic biochemical parameters using standard clinical chemistry methods and concentrations of Mn, Cu, Zn, Se, Mo, As, Cd, Hg, and Pb using inductively coupled plasma-mass spectrometry (ICP-MS). Participants also completed questionnaires on socio-demographics, medical history, lifestyle, and nutrition. Data was analyzed using the Mann-Whitney U test, Student's t-tests, Fisher exact test, logistic regression models adjusted on body mass index (BMI), age, hematocrit, and Kendall's tau correlation. Women with POI had significantly higher BMI and red blood cell (RBC) indices, including hemoglobin, hematocrit, and red cell distribution width (RDW), compared to controls. A larger proportion of POI patients resided in rural agricultural areas. Liver and kidney function assessments showed no significant differences between the groups. Adjusted models revealed that POI patients had significantly lower urinary levels of Cu, Zn, Se, Mo, Cd, Hg, and Pb than controls, while whole blood Mn levels were higher. Serum Cu levels were significantly elevated in POI patients, whereas Pb, Cd, and Hg were lower. No significant differences were observed for As. Correlation analysis showed several strong to moderate associations among TEs across biofluids, but only weak correlations were found between TEs and demographic or biochemical factors. This study suggests potential associations between TEs and POI in women. Notably, most TEs (Zn, Se, Cu, Mo, Cd, Hg, Pb) were significantly lower in the urine of the POI group, while Cu, Cd, Hg, and Pb showed significant differences in both urine and serum.

ASSESSMENT OF IRON PROFILE AND ITS CORRELATION WITH MICRO R% AND OTHER RED CELL PARAMETERS IN PATIENTS WITH CHRONIC RENAL FAILURE ON DIALYSIS AND RECEIVING ERYTHROPOIETIN INJECTION

Objectives: The objectives of the study are to correlate Micro R% with red cell indices and to assess their efficiency in detecting iron deficiency in chronic kidney disease (CKD) patients receiving erythropoietin (EPO). Methods: Red cell indices such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), MCH concentration, and red cell distribution width generated from automated analyzers frequently help in the diagnosis of iron deficiency. Micro R% is a research-only parameter in an automated analyzer while doing a complete blood count. This study is done to correlate and compare hemoglobin and biochemical parameters in healthy controls and CKD patients and to correlate the Micro R% with MCV and serum iron in detecting iron deficiency in CKD patients receiving EPO. Results: Red cell indices showed a good correlation with serum iron studies. Micro R% is a reliable parameter for the identification of iron deficiency anemia and it correlates with other red cell indices and with serum iron studies. Conclusion: Identification of iron deficiency in patients with chronic renal failure on dialysis helps us to start the treatment earlier. Anemia-related complications can be prevented and we can give a better quality of life in these patients.

Revalidation of external validity of red blood cells indices by population-based data

Revalidation of external validity of red blood cells indices by population-based data

Linear and non-linear relationships between red blood cell indices and cardiovascular risk factors: findings from the China National Health Survey

IntroductionCardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs.MethodsData from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models.ResultsHemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men.ConclusionsElevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.

Age and HbA1c in Diabetes: A Negative Association Modified by Red Cell Characteristics.

Background: While a positive correlation between age and HbA1c has been suggested in non-diabetic individuals, warranting higher HbA1c reference ranges for older adults, evidence among individuals with diabetes is less clear and may reveal an inverse trend. This study aimed to examine the relationship between age and HbA1c in a diabetic population, considering red cell parameters and other confounding factors; Methods: This cross-sectional study included 268 diabetic participants from Mongolia-Japan University Hospital (mean age 57.0 ± 9.9 years, 38.8% male, median diabetes duration 8.0 years, mean HbA1c 9.2 ± 3.3%). We analyzed the association between age and HbA1c using linear regression models, adjusting for diabetic characteristics, chronic complications, inflammation markers, and red cell indices. Subgroup analyses were conducted based on red cell distribution width (RDW) median splits; Results: A significant negative association between age and HbA1c was observed, with an unstandardized B coefficient (95% CI) of -0.112 (-0.166; -0.058, p < 0.001). This association persisted after adjustment for diabetic characteristics, complications, inflammation markers, and red cell indices (-0.115, -0.179; -0.051, p = 0.001). Subgroup analyses indicated a stronger negative association in participants with lower RDW levels (-0.174, -0.269; -0.079, p < 0.001) compared to those with higher RDW (-0.080, -0.147; -0.014, p = 0.019), suggesting that red cell characteristics may modify this relationship. No significant interactions were identified except for RDW; Conclusions: Our findings reveal a distinct negative association between age and HbA1c in diabetic individuals, independent of diabetic characteristics, complications, and inflammation markers. This association is particularly pronounced in individuals with lower RDW levels, highlighting the potential role of red cell morphology in influencing HbA1c levels with aging in diabetes.

Hemogram and inflammatory indices in pain-free periods in migraine patients without aura

ABSTRACT Objectives Since neurogenic inflammation and hemoconcentration have a prominent role in the pathophysiology of migraine, evaluation of hemogram parameters and indices showing inflammation can yield important information. In this study, we have investigated blood cell counts and ratios, systemic inflammation index (SII), systemic inflammation response index (SIRI) and red cell index (RCI) in the painless periods between pain attacks in patients with episodic migraine without aura. Methods Hemogram data of both 309 patients diagnosed with migraine without aura related to pain-free periods and 199 healthy individuals were retrospectively retrieved from hospital records. Data related to erythrocyte, leukocyte, lymphocyte, platelet, monocyte, eosinophil counts; hemoglobin, hematocrit, mean corpuscular volume, red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio (MLR), and neutrophil/monocyte ratio, SII, SIRI and RCI values were scanned to reveal intergroup differences in terms of these parameters. Results A comparison of laboratory parameters revealed that certain indices differed significantly between the migraine and control groups. MLR (p = 0.005) and RDW (p < 0.001) values were significantly lower, while platelet (p = 0.016), MPV (p < 0.001) and hematocrit (p = 0.014) were significantly higher in the migraine patient group compared to the control group. There was no significant difference between the two groups regarding other parameters. Discussion Higher hematocrit, platelet, mean platelet volume and lower monocyte/lymphocyte ratio values in this study support that hemoconcentration and chronic inflammation persist even in the absence of pain attacks in migraine patients without aura.

Malaria surveillance in schizophrenia patients and its effects on hepatic and red cell indices

Malaria surveillance in schizophrenia patients and its effects on hepatic and red cell indices

RELATIONSHIP BETWEEN ANEMIA, CRP AND HELICOBACTER PYLORI IN ELDERLY MALE POPULATION

Background: Anemia is a prevalent medical condition in elderly populations, contributing significantly to morbidity and healthcare burden globally. Helicobacter pylori (H. pylori) infection and systemic inflammation, indicated by elevated C-reactive protein (CRP), are potential contributors to anemia. Understanding the relationship between anemia, H. pylori, and CRP in elderly males can enhance diagnostic and therapeutic strategies, particularly in resource-limited settings where these conditions are highly prevalent. Objective: To determine the association between anemia, CRP levels, and H. pylori infection in elderly males. Methods: This cross-sectional observational study was conducted over six months from January 1 to June 30, 2023, at a tertiary care hospital in Rawalpindi. A total of 300 male participants aged above 65 years were recruited. After informed consent, 2cc venous blood samples were collected and analyzed for hemoglobin levels, red blood cell indices, and CRP-Q levels using Sysmex XP-100 and Beckman Coulter automated analyzers. Stool samples were tested for H. pylori antigen using the H. PYLORI QUIK CHEK enzymatic immunoassay. Data were statistically analyzed using SPSS version 22. Results: Out of 300 participants, 270 (90%) were anemic, with 90 (33.3%) classified as mild anemia, 145 (53.7%) as moderate, and 35 (12.9%) as severe anemia. Microcytic anemia was the most common subtype (60.7%), with 158 (96.3%) of the 164 microcytic anemia cases testing positive for H. pylori. CRP-Q was elevated in 237 (87.7%) individuals, with a strong correlation observed between elevated CRP levels, H. pylori positivity, and microcytic anemia. H. pylori stool antigen was positive in 242 (89%) participants, particularly among those with anemia. Conclusion: This study highlights a strong association between anemia, H. pylori infection, and CRP levels in elderly males, emphasizing the importance of addressing H. pylori infection as part of anemia management in this population.

The Utility of Hypochromic Markers in the Detection of Latent Iron Deficiency in Women in their First Trimester of Pregnancy

Background and Objectives: While iron deficiency anemia is a documented common problem in pregnancy, there is limited information on latent iron deficiency. Accordingly, we aimed to determine the frequency of the latter in the first trimester of pregnancy and assess the utility of new hypochromic markers in screening for it. Methods: In this cross-sectional study, we recruited 100 pregnant women in their first trimester attending the Maternity Hospital in the period between January and March 2023. Inclusion criteria included hemoglobin &gt;11.0 g/dl, and no iron supplements. Serum ferritin was used to classify patients into latent iron deficiency or iron replete state. While a hematology analyzer was used to determine the new hypochromic markers: namely %Hypo-He, Ret-He, % Hyper-He, RBC-He. Results: The mean age of enrollees was 29.3 (SD 5.5) years and included 38% with latent iron deficiency (hemoglobin &gt; 11 g/dl and S. ferritin ? 30 ng/ml). The latter group had significantly lower hemoglobin (P=0.03), and %Hypo-He (P&lt;0.001) than iron replete women. While neither MCV, MCH, reticulocyte counts, Ret-He, or RBC-He were different. Furthermore, %Hypo-He was significantly negatively correlated with serum ferritin (P&lt;0.001) and had a fair discriminating power between latent iron deficiency and iron replete status. Conclusion: High prevalence of latent iron deficiency was documented among pregnant women in their first trimester; Furthermore, %Hypo-He was a better red cell index to screen for it. Because of its high frequency and anticipated impact on fetal and maternal health, routine screening for latent iron deficiency in pregnancy may be warranted.

Comparative Assessment of Blood Parameters Including RBC, Hb, PCV, Red Cell Indices, Serum Ferritin, and Salivary Candidal Growth in Female Patients with Iron Deficiency Anemia and Iron Deficiency

ABSTRACT Background: Iron deficiency anemia (IDA) is a microcytic-hypochromic anemia prevalent in African and South Asian countries including India. Along with systemic, it presents various oral manifestations that can be diagnosed in dental setups. Literature suggests that there is a state of iron deficiency before it manifests as anemia, which eventually creates an immunodeficient body state that predisposes to various opportunistic infections such as oral candidiasis. Objectives: The present study was designed to evaluate and compare various components of the blood picture including the hemoglobin (Hb%), red blood cell (RBC) count, RBC indices, hematocrit, peripheral blood smear and serum ferritin between iron deficiency (ID), IDA, and healthy subjects. The study also attempts to compare and assess the salivary samples of ID for Candida growth. Material and Methods: A total of 252 female patients of age groups ranging from 18 to 70 years were selected. The study consisted of three study groups, namely, Group A, IDA patients (clinical manifestations with pallor); Group B, ID patients (clinical manifestations without pallor); and Group C, age-matched healthy controls, with 84 in each group. The blood samples were collected to evaluate the hematological parameters including Hb%, RBC count, RBC indices, hematocrit, peripheral blood smear, and serum ferritin. Later, a saliva sample was collected from all study groups to assess the Candida growth. The obtained data were subjected to statistical analysis using SPSS version 20.0 software. Results: The results demonstrated that ID patients had normal blood parameters as healthy controls except for serum ferritin, while IDA patients had significantly (P &lt; 0.001) lower hemoglobin, RBC count, and blood cell indices, specifically mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and hematocrit compared to ID and healthy controls. A significant finding is that like IDA patients, ID patients exhibited reduced serum ferritin levels. Contrary to the IDA group, only a small percentage of ID patients had Candida growth, although this was not statistically significant. Conclusion: Within the limitations of the current study, the results showed significantly reduced serum ferritin levels in ID, while other parameters were within the normal limits, and found tendency to develop Candida growth compared with the control subjects. Further studies are warranted to establish the association and causal relationship.

Prevalence and screening of hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in Yemeni blood donors

ABSTRACT Hemoglobinopathies and Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency pose significant health threats in Yemen, which can be alleviated through robust preventive strategies, highlighting the importance of implementing a cost-effective and efficient blood donor screening method to facilitate early diagnosis and management of erythrocyte disorders, ultimately improving both donor safety and patient health outcomes. Objectives This study aimed to determine the prevalence of total blood cell abnormalities, hemoglobinopathies and G6PD deficiency and evaluate the efficacy of red blood cell (RBC) indices, mentzer index (MI) and naked-eye single tube red cell osmotic fragility (NESTROF) test as screening tools for diagnosis of β thalassemia trait among Yemeni blood donors. Methods A cross-sectional study was conducted with 106 volunteer blood donors who met the national standard criterion of blood donation. Various tests were performed, including complete blood count (CBC), serum ferritin, sickling test, G6PD assay, NESTROF test and high-performance liquid chromatography (HPLC). Results The prevalence of hematological abnormalities among blood donors reached 68.9%, with functional RBC abnormalities at 51.9%, leukopenia at 10.4%, thrombocytosis at 1.9%, and thrombocytopenia at 4.7%. Additionally, hemoglobinopathies were found in 21.7% of donors, with β-thalassemia trait at 3.8%, sickle cell trait at 1.9%, and suspected α-thalassemia trait at 16%, while G6PD deficiency and iron deficiency were present in 12.3% and 17.9% of donors, respectively. The NESTROF test, MCV and MCH demonstrated a sensitivity rate of 100%. MI and MCH exhibited the highest specificity followed by NESTROF test in the screening of β-thalassemia trait. Conclusions The prevalence of hemoglobinopathies and G6PD deficiency appear to be common among Yemeni blood donors. These results emphasize the necessity of comprehensive blood donation screening programs to safeguard the blood supply and promote early detection and management of hemoglobinopathies and G6PD deficiency in Yemen.

Uticaj TMPRSS6 genotipova na parametre statusa gvožđa kod pacijenata sa stabilnim oblikom HOBP

Background: The SNP rs855791 has been linked to increased hepcidin levels, variations in serum iron, transferrin saturation and red blood cell indices. Our goal was to determine the prevalence of this polymorphism among COPD patients and to assess its impact on iron status parameters in patients with stable COPD. Methods: We analysed iron status parameters and genetic data from 29 COPD patients with wild-type genotype (WT group) and 65 COPD patients with either homozygous or heterozygous genotype (HH group). Additionally, the prevalence of SNP rs855791 was assessed in 192 volunteers. Results: The frequency distribution of SNP rs855791 was comparable between the COPD patients and control subjects (p=0.791). Iron status parameters were within their respective reference values and showed neither statistically nor clinically significant difference between the WT and HH group of COPD patients. However, after excluding patients with (sub)clinical vitamin B12 deficiency and/or hypoxemia, WT group of patients exhibited significantly lower erythropoietin levels (p=0.015). The area under the curve for erythropoietin was 0.688 (95% CI: 0.545-0.830, p=0.015), with an optimal cut-off of 9.74, sensitivity of 61.2% (95% CI: 58.1-64.3) and specificity of 65.0% (95% CI: 61.8-68.3).Conclusions: Iron status parameters do not differ between WT and HH groups of stable COPD patients. Statistical but not clinical difference in EPO levels was observed in a subgroup of patients. In addition to promoting erythropoiesis, EPO may regulate hepcidin levels and thus influence the development of iron deficiency and/or anaemia. Also, EPO's direct effect on immune cells and down-regulation of inflammatory reactions should be considered in this context.

Comparative Study of Red Blood Cell Parameters in Different Hemoglobinopathies Diagnosed by HPLC at a Tertiary Care Hospital, Rajkot, Gujarat

Background: Inherited disorders of hemoglobin (hemoglobinopathies) are the most common genetic disorders in the world with 7% prevalence. Thalassemia and sickle cell anemia are the most prevalent hemoglobinopathies in India. Screening and diagnosis of hemoglobinopathies require a comprehensive evaluation combining clinical and family history, blood counts, red blood cell indices, and molecular analysis. Aims and Objective: (1) To differentiate the type of hemoglobinopathies on the basis of red cell parameters, (2) to assess the spectrum of hemoglobinopathies, and (3) to study the age at diagnosis and genderwise distribution of various hemoglobinopathies. Material and Methods: A prospective observational study over a period of 1 year (August 2020 to July 2021) at a tertiary care hospital, Rajkot, Gujarat. All indoor patients’ samples were sent for complete blood count (CBC), peripheral smear examination, reticulocyte count, sickling test, and high-performance liquid chromatography (HPLC). Result: A total of 140 subjects were included in the final analysis. The mean age at diagnosis was 24.7 ± 10.5 years; 48 participants were male, and the remaining 92 were female with an M:F ratio of 0.5:1. The most common hemoglobinopathy in this study was sickle cell trait (40 cases, 28.6%). Conclusion: To reduce the burden of various hemoglobinopathies, screening is recommended as a part of antenatal checkup and in infants after 6 months of age in high-prevalence districts for particular hemoglobinopathies via CBC including RBC indices and HPLC.