Red Cells Research Articles

Molecular and haematological characterisation of haemolytic anaemia associated with biallelic KLF1 mutations: a case series

AimsKrüppel-like factor 1 (KLF1) is an erythroid-specific transcription factor playing an important role in erythropoiesis and haemoglobin (Hb) switching. Biallelic KLF1 mutations can cause haemolytic anaemia with thalassaemia-like syndromes but...

Seasonal Variances in General Urine Examination Findings among Al-Yarmouk Teaching Hospital Patients

Background: Urinalysis is a common test done for several reasons; for instance, in UTI looking for, hematuria or pseudo-hematuria, pyuria, crystalluria and also looking for different microorganisms (etc...), many laboratories perform either a regular test light microscopy, or examine varying dilutions of urine sediment and fields of view with or without the use of stains or polarization, while other laboratories used analysis of urine using automated system. As being a human; the biological sex(female or male) and broadly influences diverse immune phenotypes, including immune responses to diseases at mucosal surfaces, all contribute to how an organism will respond to diseases of the urinary tract, on the other hand, a close relationship between four seasons and the incidence of UTI has been detected in various areas of the world, where the seasons alternate in a year, and the temperature fluctuates widely among these seasons. Methods: present study was conducted on midstream sample was collected for acquiring accurate results from (68899) individuals (40800 females and 28099 males), these subjects were clinically suspected to have UTI, who were referred to the Department of Teaching Laboratories in AL-Yarmouk Teaching Hospital at Baghdad / Iraq, between January 2020 and December 2023, which examined by; Urilyzer 500 PRO (Analyticon) with Urine strips (dipstick) and Optical Microscope BA 210 (Motic). Results: A total of 68899 urine specimens were tested, of which 28099 male (40.8%) and 40800 female (59.2%) with the highest percentage of urinalysis in 2022 (33.2%), furthermore, the higher percentage of urinalysis parameters was scored in 2021 as follows; pus cells 9012 (49.3%), red blood corpuscles 5284 (48.9%) and crystalluria 3956 (44.2%) with the most common type of crystal was amorphous urate 5032 (56.2%), while highest percentages of microorganisms 1050 (40.3%) in year 2022 , and Bacteria was exhibited the highest percentages 2036 (78.1%). Current study recorded significantly differences between males and females in all urine parameters which was higher percentage in female than male and in the Seasons of (Summer and Autumn) , during the four years of this study. Conclusion: This study registered more accurate diagnostic results of UTI according to the urinary parameters in the microscopic routine urinalysis(centrifugation at 300xg at 5 min) when compared to machines (Urilyzer 500 PRO test/Urine strips) which frequently miss that , in addition, hot season in Iraq could affect to increase the seasonally variable incidence of UTI , as well, increased percentages and frequency of urinary parameters which observed in 2021-2022 out of four study years may indicates, high likelihood side effects of Covid-19 pandemic disease in study persons involved.

A voluntary transfusion recipient registry in Korea as a database for blood group antibodies.

Several types of transfusion-related registries have been developed to improve patient outcomes and blood banks. In Korea, a transfusion program functioning as a blood group antibody database and a reference laboratory has been in operation since July 2013. This study was conducted to determine the current status of blood group antigens and antibodies in Korea and propose a model for registries in the field of transfusion medicine. Cases with unexpected red cell antibodies were registered online in the voluntary transfusion registry. Specific antigen-negative frequencies were calculated based on the recorded data. To determine the frequencies of RhCE antigens, data added via the Blood Information Sharing System were also analyzed. Data added to the registries between July 2013 and June 2022 were included in the analysis. Among 9,048 antibody cases registered from 29 hospitals, anti-E alone was identified most commonly, followed by anti-E and c, anti-C and e, anti-Lea, and anti-M (2,202, 1,792, 757, 618, and 383 cases, respectively). The frequencies of E-, E-c-, C-e-, Le(a-), and M- were 49.1%, 41.6%, 9.1%, 69.4%, and 21.8%, respectively. The distributions of antibodies and antigen frequencies were estimated through the transfusion registry. Antigen frequencies were calculated based on the results of antigen typing of red blood cell components performed at the time of issuing. The online transfusion registry serving as a blood group antibody database is useful for determining the frequencies of blood group antigens and antibodies.

Dietary Curcumin Nanoparticles Improve Growth Performance, Oxidative Status and Immune Response of European Seabass (Dicentrarchus Labrax)

Abstract A 90 days of feeding trial was employed for evaluating the effects of dietary supplementation with curcumin nanoparticles (CURNPs) on growth performance, hematological and biochemical parameters, immune response, antioxidant status, and intestinal and hepatic architecture in European seabass (Dicentrarchus labrax) fingerlings. Fish (n = 300, initial body weight = 10.02 g ± 0.11 g) received supplementary CURNPs at rates of 0 (control; CURNPs0), 50 (CURNPs50), 100 (CURNPs100) and 150 (CURNPs150) mg/kg diet for 90 days. Growth performance (final body weight (FBW), daily weight gain (DWG), weight gain (WG), relative growth rate (RGR), and protein efficiency ratio (PER)) and feed uptake (feed conversion rate (FCR)) were improved significantly in CURNPs (100 and 150 mg/ kg)-supplemented groups. The hematological parameters red blood corpuscles (RBCs), hemoglobin (Hb), and packed cell volume (PCV) were improved significantly (P<0.001) in CURNPs150 and CURNPs100 groups, while CURNPs150 had the lowest values of monocytes (P = 0.019) and heterophils (P<0.005) when compared with other groups. Glucose was higher and lipid profile (total cholesterol and triglycerides) were lower in all CURNPs-supplemented groups as compared to the control group. Fish fed with CURNPS at various levels exhibited remarkable increase in digestive enzymes (amylase and lipase), immune markers (immunoglobulin G (IgG), lysozyme and phagocytic indices), and antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)). A noticeable decrease (P<0.05) in malondialdehyde (MDA) and considerable upregulation of hepatic insulin-like growth factor 1 (IGF1) and interleukin-1beta (IL-1β) mRNA levels were found in CURNPs-supplemented fish in a dose-dependent manner. The down regulation of hepatic heat shock protein 70 (HSP70) was observed in CURNPs150. Intestinal and hepatic architectures were improved significantly by CURNPs. In conclusion, CURNPs supplementation improved growth performance, feed consumption and digestion, hematological and biochemical markers, immune response, and redox homeostasis in D. labrax. Therefore, CURNPs could be supplemented in the diets of D. labrax as a natural alternative to promote overall performance.

Prediction of in-hospital Mortality of Intensive Care Unit Patients with Acute Pancreatitis Based on an Explainable Machine Learning Algorithm.

Acute pancreatitis (AP) is potentially fatal. Therefore, early identification of patients at a high mortality risk and timely intervention are essential. This study aimed to establish an explainable machine-learning model for predicting in-hospital mortality of intensive care unit (ICU) patients with AP. Data on patients with AP, including demographics, vital signs, laboratory tests, comorbidities, treatment, complication, and severity scores, were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) and the eICU collaborative research database (eICU-CRD). Based on the data from MIMIC-IV, we used the least absolute shrinkage and selection operator algorithm to select variables and then established 9 machine-learning models and screened the optimal model. Data from the eICU-CRD were used for external validation. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, decision curve, and calibration plots were used to assess the models' efficacy. Shapley's additive explanation values were used to explain the model. Gaussian naive Bayes (GNB) model had the best performance on the data from MIMIC-IV, with an AUC, accuracy, sensitivity, and specificity of 0.840, 0.787, 0.839, and 0.792, respectively. The GNB model also performed well on the data from the eICU-CRD, with an AUC, accuracy, sensitivity, and specificity of 0.862, 0.833, 0.848, and 0.763, respectively. According to Shapley's additive explanation values, the top 4 predictive factors were maximum red cell distribution width, minimum saturation of blood oxygen, maximum blood urea nitrogen, and the Sequential Organ Failure Assessment score. The GNB model demonstrated excellent performance and generalizability in predicting mortality in ICU patients with AP. Therefore, it can identify patients at a high mortality risk.

Effect of Dietary Supplementation of Tejpatta (Cinnamomum tamala) Leaf Powder as Feed Additive on Growth Performance and Haemato-biochemical Parameters of Broilers

Background: Tejpatta leaves are well known for their use as spice in food for taste and aromatic purposes. It is mainly used for flavoring food and widely used in pharmaceutical preparation because of its hypoglycemic, stimulant, carminative, antidiabetic, antibacterial, antioxidant, anti-ulcer and antimicrobial properties. Keeping the aforementioned properties in view, the present study was to evaluate the effect of dietary supplementation of Tejpatta leaf powder on growth performance and haemato-biochemical parameters of broilers for boosting poultry industry production. Methods: Two hundred and twenty five day-old chicks were randomly assigned into five dietary treatment groups (T1-T5) using CRD, each consisting of 45 chicks with roughly equal average body weights. Each group of 45 chicks was subdivided into three replicates (R1, R2 and R3) having 15 chicks per replicate. The T1 group fed basal diet only, while T2, T3, T4 and T5 groups were fed Tejpatta leaf powder @ 0.25%, 0.75%, 1.25% and 1.75%, respectively, along with basal diet. Result: Significant (P less than 0.01) effect on growth characteristics was noticed in broiler chicks due to dietary supplementation of Tejpatta leaf powder. Significantly (P less than 0.01) higher body weight, weekly body weight gain, average daily body weight gain and performance index was noticed in T4 group and lowest was observed in T1 group. Significantly (P less than 0.01) higher feed intake was observed in T5 group and lowest was in T1 group. Lowest feed conversion ratio was observed in T4 group and highest in T1 group. Non-significant effect on hemoglobin, packed cell volume, red blood corpuscle count, serum glucose, total protein and cholesterol and creatinine levels was observed in various treatment groups. It was concluded that supplementing broiler diet with Tejpatta leaf powder @ 1.25% could be beneficial for improving broiler chick growth performance and hemato-biochemical parameters while having no adverse effects on broiler chicks.

The effect of garlic formulation on some hematological parameters and organ weight of male and female Wister albino rats

The study was conducted to investigate the impact of garlic formulation on certain haematological parameters and organ weights in both male and female rats. Haematological data, including the count of red blood corpuscles (RBC), the volume of packed cells (PCV), the count of white blood corpuscles (WBC), and the count of platelets, were evaluated using a fully automated haematology analyser. The liver, right kidney, left kidney, heart, and spleen of the rats were weighed to determine their respective organ weights. A total of thirty (30) albino Wister rats, consisting of both males and females, were randomly assigned to five groups, with six animals in each group. Group 1 acted as the positive control and was given 100% standard feed. Group II rats were given a mixture of 10% garlic and 90% feed. Group III animals were provided with a diet consisting of 20% garlic and 80% feed. Group IV received a diet containing 40% garlic and 60% feed. The final group, Group V, was fed a diet consisting of 80% garlic and 20% feed daily for a period of 21 days. The feed formulation was assessed at concentrations of 10, 20, 40, and 80 g/dl, based on the weight of the animal. The findings indicated a noteworthy (P<0.05) reduction in white blood cell count (WBC) and lymphocyte count (LYM). There were no statistically significant changes (P>0.05) observed in the levels of haemoglobin (HGB), haematocrit (HCT), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH) when compared to the control group. Furthermore, there was a noteworthy (P<0.05) reduction in HGB, MCV, and MCH when the rats reached a body weight of 80 g/100dl. The results indicated a statistically significant (P<0.05) reduction in the weight of the left kidney, heart, and spleen, as well as in the liver and right kidney weights at 20, 40, and 80 g/dl body weight. There were no statistically significant differences (P>0.05) in the body weight of the liver and right kidney, which were both 10g/dl. Ultimately, the use of garlic formulation in appropriate dosages can impact certain haematological markers and the weights of organs.

Breakpoint regions of an RHD-CE(4-9)-D allele and a rare JK allele in a Pacific Islander individual.

Among 710 RHD alleles, 3 alleles have been shown to express CcEe antigens and, among 67 hybrid alleles of the RHD gene, 2 alleles have evolved to include RHCE exons 4-9. No breakpoint region had been described for such RHD-CE(4-9)-D hybrid alleles. In the Kidd blood group system, the JK*02N.01 null allele is found with high prevalence in the Polynesian population. We investigated a self-identified Pacific Islander with discrepant serologic and molecular results for his C and Jkb antigens. Another 8 samples with genotype-phenotype discrepancies in the Kidd blood group system were assessed. A combination of published molecular methods and commercial kits were applied to analyze the RHD, RHCE, and SLC14A1 gene sequences, as were hemagglutination tests to determine the serologic phenotypes. Nucleotide sequencing of the RHD gene in the index case, including relevant intron stretches, and cDNA identified an RHD-CE(4-9)-D hybrid allele. Nucleotide sequencing of his RHCE gene confirmed the presence of 2 RHCE*ce alleles despite expressing the C antigen. Sequencing of his SLC14A1 gene documented the JK*02N.01 null allele. In the other 8 samples, 5 previously known SLC14A1 nucleotide substitutions were identified. The JK*02N.17 allele was determined to be Jkb-positive. We determined the 2 breakpoint regions of his RHD-CE(4-9)-D hybrid allele, which was likely distinct from the 2 previously published hybrid alleles due to the differences in the linked RHCE allele. His RHD variant was shown to express the C antigen. An SLC14A1 substitution was underlying his unexpected Jkb-negative phenotype. In a quality improvement project, we resolved 8 samples with similarly discrepant results between Jk serology and red cell genotyping.

Enhanced coagulation cascade activation and styptic effects of Zn@SiO2 nanocomposite

Humans often have bleeding, which exerts substantial selective pressure on the coagulation system to optimize hemostasis in a variety of situations. Uncontrolled hemorrhage due to severe trauma leads to morbidity and mortality. Although nonbiological surfaces such as silicates can activate coagulation factor XII (FXII), the presence of Zn (Zinc) in the material stimulates and activates the various steps in the coagulation cascade. This results in blood clotting. The Zn@SiO2 nanocomposite has an excellent hemostatic property that establishes hemostasis by activating the factors responsible for the formation of a stable clot called fibrin mesh. This can be used as a hemostatic agent during surgeries and in any other trauma condition related to bleeding. Zn@SiO2 was synthesized and characterized with XRD, FTIR and HRTEM. It is analyzed for its RBC (Red Blood Corpuscles) aggregation and Platelet adhesion ability, fibrin formation, thrombus formation and prothrombin time (PT), Activated Partial Thromboplastin Time (aPTT), D-dimer for its ability to activate the coagulation cascade to achieve stable clotting.

The rheology of interactions between leukocytes, platelets and the vessel wall in thrombo-inflammation.

Leukocytes and platelets must adhere to the wall of blood vessels to carry out their protective functions in inflammation and haemostasis. Recruitment is critically dependent on rheological variables (wall shear rate and stress, red cell aggregation and haematocrit) which affect delivery to the vessel wall as well as velocities and forces experienced there. Leukocyte recruitment is efficient only up to wall shear rates of about 300s-1 and usually restricted to low-shear post-capillary venules in inflammation. Being smaller, platelets experience lower velocities and shear forces adjacent to the wall and can adhere at much higher shear rates for haemostasis in arteries. In addition, we found quite different effects of variations in haematocrit or red cell aggregation on attachment of neutrophils or platelets, which also assist their separate recruitment in venules or arteries. However, it has become increasingly evident that inflammatory and thrombotic responses may occur together, with platelets promoting the adhesion and activation of neutrophils and monocytes. Indeed, it is 30 years since we demonstrated that platelets could cause neutrophils to aggregate in suspension and, when attached to a surface, could support selectin-mediated rolling of all leukocytes. Thrombin-activated platelets could further induce neutrophil activation and immobilisation. In some conditions, platelets could bind to intact endothelial monolayers and capture neutrophils or monocytes. Subsequently, we found that extracellular vesicles released by activated platelets (PEV) fulfilled similar functions when deposited on surfaces or bound to endothelial cells. In murine models, platelets or PEV could act as bridges for monocytes in inflamed vessels. Thus, leukocytes and platelets are rheologically adapted for their separate functions, while novel thrombo-inflammatory pathways using platelets or PEV may underlie pathogenic leukocyte recruitment.

Gradient Hydrogels Spatially Trapped Optical Cell Profiling for Quantitative Blood Cellular Osmotic Analysis.

The quantitative exploration of cellular osmotic responses and a thorough analysis of osmotic pressure-responsive cellular behaviors are poised to offer novel clinical insights into current research. This underscores a paradigm shift in the long-standing approach of colorimetric measurements triggered by red cell lysis. In this study, we engineered a purpose-driven optofluidic platform to facilitate the goal. Specifically, creating photocurable hydrogel traps surmounts a persistent challenge─optical signal interference from fluid disturbances. This achievement ensures a stable spatial phase of cells and the acquisition of optical signals for accurate osmotic response analysis at the single-cell level. Leveraging a multigradient microfluidic system, we constructed gradient osmotic hydrogel traps and developed an imaging recognition algorithm, empowering comprehensive analysis of cellular behaviors. Notably, this system has successfully and precisely analyzed individual and clustered cellular responses within the osmotic dimension. Prospective clinical testing has further substantiated its feasibility and performance in that it demonstrates an accuracy of 92% in discriminating complete hemolysis values (n = 25) and 100% in identifying initial hemolysis values (n = 25). Foreseeably, this strategy should promise to advance osmotic pressure-related cellular response analysis, benefiting further investigation and diagnosis of related blood diseases, blood quality, drug development, etc.

Association Between Red Blood Cell Distribution Width and Coronary Calcification in Patients Referred for Invasive Coronary Angiography.

This study aimed to determine whether red cell distribution width (RDW) is associated with coronary calcification. A total of 4796 patients who underwent coronary computed tomography angiography and subsequent invasive coronary angiography were consecutively enrolled. Coronary artery calcium score (CACS), demographic, clinical, and laboratory data were collected from electronic medical records. RDW were expressed in two forms, as a coefficient of variation (CV) or as a standard deviation (SD). Multivariable ordinal logistic regression was used to investigate the association of RDW with CACS grades (CACS 0-99, 100-399, 400-999, and >1000). A significant association was found between elevated RDW-SD and higher CACS grades after full adjustment (adjusted OR per 1-SD increase: 1.11, 95% CI: 1.05-1.18; P < .001), while no significant association was found between RDW-CV and CACS grades. When RDW-SD was analyzed as a categorical variable, it was primarily the 4th quartile of RDW-SD that was associated with elevated CACS grades compared with the 1st quartile (adjusted OR: 1.25, 95% CI: 1.07-1.46; P = .006), while the 2nd and 3rd quartiles showed no significantly higher risk. RDW-SD is a more robust biomarker for coronary calcification compared with RDW-CV.

A prospective observational study of red cell distribution width (RDW) as an outcome marker in Critically ill children admitted to a Pediatric Intensive Care Unit in a tertiary care hospital in central India

Background Critically ill pediatric patients often present with a broad spectrum of conditions, and early prognostic markers are essential for guiding clinical decisions. Red Cell Distribution Width (RDW), a measure of the variability in red blood cell size, has been associated with various health conditions. Methods The study will be conducted over two years at a tertiary care hospital in Central India. Critically ill children between the ages of 1 month and 18 years admitted to the PICU will be consecutively enrolled after obtaining informed consent. Demographic data, vital signs, diagnoses, laboratory results, and relevant scores (PELOD-2 and SOFA) will be recorded. Outcome variables will be documented, including ICU stay duration, mechanical ventilation days, ionotrope usage, development of Acute Kidney Injury (AKI), renal replacement therapy, and outcome (death or discharge). Statistical analysis will involve t-tests, chi-square tests, ROC curve analysis, sensitivity, specificity, positive predictive value, and negative predictive value calculations. Expected results The study aims to provide insights into the potential of RDW as a predictor of morbidity and mortality in critically ill pediatric patients. Comparison with established scoring systems will contribute to understanding the practical significance of RDW in clinical decision-making.

Combined delta neutrophil index and red blood cell distribution width as a new biomarker to predict endometriosis

The aim of this study was to evaluate the use of delta neutrophil index (DNI) in predicting endometriosis. A retrospective, case-control study was performed in a tertiary care center. DNI, red cell distribution width (RDW), and other blood parameters obtained from complete blood counts of 267 patients, consisting of 122 (45.7%) endometriosis patients with proven pathology reports of stages 3-4, and a control group of 145 women who underwent laparoscopy for simple ovarian cyst and/or diagnostic purposes and had normal histopathology, were compared. Receiver operating characteristic and logistic regression analyses were performed. DNI and RDW were significantly higher in endometriosis patients than in the control group (p=0.034 and p=0.003, respectively). Other parameters obtained from complete blood counts (leukocyte, neutrophil, lymphocyte, monocytes, and platelet counts and neutrophil-to-lymphocyte ratio), did not differ (p>0.05). For DNI, at a cut-off value of 0.025, area under the curve (AUC) was 0.572 and it was statistically significant [p=0.042; 95% confidence interval (CI): 0.503-0.642, sensitivity: 45.9%, specificity: 67.6%, Youden’s index: 0.135]. For RDW, AUC: 0.601 for cut-off value of 13.65 was statistically significant (p=0.004, 95% CI: 0.553-0.669, sensitivity: 50.8%, specificity: 67.6%, Youden’s index: 0.184). The logistic regression model established with the combined marker obtained by multiplying the DNI and RDW was statistically significant (p<0.001, Nagelkerke R2=0.72, 95% CI: 2.58-47.26, B: 2.40, negative predictive value: 78.6%, positive predictive value: 37.7%). DNI, a new inflammatory marker, and RDW, known to be associated with inflammation, may be useful minimally invasive biomarkers of endometriosis.

Association between Red cells distribution width and glycemic control among people with type 2 diabetes.

Objective: To evaluate Red blood cell distribution width (RDW) in people with type 2 diabetes and its relationship with glycemic control. Study Design: Retrospective study. Setting: Baqai Institute of Diabetology and Endocrinology, Baqai Medical University. Demographic, Clinical and Biochemical Data were retrieved from hospital management system of BIDE. Period: September 2018 to April 2019. Material &amp; Methods: Ethical approval was obtained from the Institutional Review Board of BIDE. Based on the HbA1c values, patients were divided into two groups, HbA1c &lt; 7.0% and HbA1c ≥ 7.0%. RDW calculated from RBC histogram in Nihon Kohden fully automated analyzer. Results: RDW found 13.9±1.88 and 13.57±1.64 (p-value 0.018) in good and poorly controlled glycemic groups respectively. Poor glycemic group had higher levels of white cell count (9.58±4.34) and Triglycerides (170.12±129.13) (p-value &lt;0.05), whereas controlled glycemic group demonstrated higher levels of BMI (29.03±6.01), MCV (84.36±7.81) and HDL (33.75±12.31). RDW was directly correlated with gender (p-value &lt;0.0001) and duration of diabetes (p-value 0.01), and showed significant and inverse correlation with HbA1c. Age, blood pressure, duration of diabetes, serum LDL cholesterol, and the CBC values demonstrated no significant differences between the both groups. Conclusion: We found significant correlation between RDW and glycemic control.

Rosetta gen. nov. (Chlorophyta): Resolving the identity of red snow algal rosettes.

Thick-walled rosette-like snow algae were long thought to be a life stage of various other species of snow algae. Rosette-like cells have not been cultured, but by manually isolating cells from 38 field samples in southern British Columbia, we assigned a variety of rosette morphologies to DNA sequence. Phylogenetic analysis of Rubisco large-subunit (rbcL) gene, ribosomal internal transcribed spacer 2 (ITS2) rRNA region, and 18S rRNA gene revealed that the rosette-like cells form a new clade within the phylogroup Chloromonadinia. Based on these data, we designate a new genus, Rosetta, which comprises five novel species: R. castellata, R. floranivea, R. stellaria, R. rubriterra, and R. papavera. In a survey of 762 snow samples from British Columbia, we observed R. floranivea exclusively on snow overlying high-elevation glaciers, whereas R. castellata was observed at lower elevations, near the tree line. The other three species were rarely observed. Spherical red cells enveloped in a thin translucent sac were conspecific with Rosetta, possibly a developmental stage. These results highlight the unexplored diversity among snow algae and emphasize the utility of single-cell isolation to advance the centuries-old problem of disentangling life stages and cryptic species.

Adverse transfusion reactions following transfusion of blood and blood products in a tertiary care hospital: A step toward hemovigilance

Background: Transfusion of blood and blood products is a double-edged sword, so it should be used judiciously. The primary aim of the centralized hemovigilance program is to improve transfusion safety. Aims and Objectives: To determine the frequency, distribution, and types of transfusion reactions (TRs) occurring in patients, reported to the blood center in a tertiary care hospital in North East India. Materials and Methods: A retrospective study was conducted in State of The Art Model Blood Center, Assam Medical College and Hospital for 1 year from July 2022 to June 2023. Data were collected from TR records as per the hemovigilance reporting format and analyzed. Results: During the study, 38,165 blood products were issued. 41 (0.11%) TRs were recorded, out of which 25 (61%) occurred with packed red cell transfusion followed by whole blood transfusion (39%). The most common type was febrile non-hemolytic TR (51.2%) followed by allergic reactions (39%). Conclusion: The frequency of adverse TRs was low (0.11%), which may be due to the management of a few cases by the treating clinician itself. Most reactions occurred with packed red blood cells (PRBC) transfusion, the most common type being febrile non-hemolytic TR, which may be due to the presence of leukocytes, inflammatory mediators in leftover plasma during PRBC preparation, which can be standardized by the use of leukoreduced blood products. Hemovigilance will help to strengthen the quality and safety of blood transfusion.

Influence of Frequent Phlebothomy on Blood Iron Concentration, Haematological, Metabolic and Endocrine Parameters in Rams

Abstract Frequent phlebotomies, even when only a small volume of blood is taken for diagnostic purposes, can lead to the development of iron deficiency with hematological and metabolic changes. The study aimed to determine the influence of frequent blood loss by phlebotomy on blood iron concentration (Fe), hematology, metabolic and endocrine parameters and their relationships. Blood samples were collected from 30 blood donor rams for 6 consecutive weeks, with approximately 10% of blood collected weekly. Such chronic blood loss resulted in a decrease in Fe. Indicators of iron transport in the bloodstream changed, so the value of total iron-binding capacity (TIBC) and unsaturated iron-binding capacity (UIBC) increased, while the value of transferrin saturation percentage (TS%) decreased. Hematological changes included a decrease in red blood cells, hemoglobin, mean red blood cell volume and hematocrit and a tendency for reticulocyte count and red cell distribution width to increase. Chronic blood loss resulted in a specific metabolic response that included the increase in glucose, cholesterol, triglycerides, aspartate-aminotransferase, and insulin resistance, while thyroxine, triiodothyronine and cortisol decreased and there was a tendency for lactate to increase and BHB to decrease. The mentioned blood parameters correlated with Fe and additionally showed greater changes when Fe was extrapolated to the level of clinical deficit (Fe=9μmol/L). These correlations suggest the need to monitor the metabolic and endocrine status during chronic blood loss, in addition to Fe and erythrocyte indices. Compared with previous results in other animal species, Fe may have a direct influence on metabolic processes in rams.

Association between biomarkers of inflammation and dyslipidemia in drug resistant tuberculosis in Uganda

BackgroundActive tuberculosis (TB) significantly increases the risk of cardiovascular disease, but the underlying mechanisms remain unclear. This study aimed to investigate the association between inflammation biomarkers and dyslipidemia in patients with drug-resistant TB (DR-TB).MethodsThis was a secondary analysis of data from a cross-sectional multi-center study in Uganda conducted 2021. Participants underwent anthropometric measurements and laboratory tests included a lipid profile, full haemogram and serology for HIV infection. Dyslipidemia was defined as total cholesterol > 5.0 mmol/l and/or low-density lipoprotein cholesterol > 4.14 mmol/l, and/or triglycerides (TG) ≥ 1.7 mmol/l, and/or high density lipoprotein cholesterol (HDL-c) < 1.03 mmol/l for men and < 1.29 mmol/l for women. Biomarkers of inflammation were leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts, as well as neutrophil/lymphocyte (NLR), platelet/lymphocyte, and lymphocyte/monocyte (LMR) ratios, mean corpuscular volume (MCV), and the systemic immune inflammation index (SII) (neutrophil × platelet/lymphocyte). Modified Poisson Regression analysis was used for determining the association of the biomarkers and dyslipidemia.ResultsOf 171 participants, 118 (69.0%) were co-infected with HIV. The prevalence of dyslipidemia was 70.2% (120/171) with low HDL-c (40.4%, 69/171) and hypertriglyceridemia (22.5%, 38/169) being the most common components. Patients with dyslipidemia had significantly higher lymphocyte (P = 0.008), monocyte (P < 0.001), and platelet counts (P = 0.014) in addition to a lower MCV (P < 0.001) than those without dyslipidemia. Further, patients with dyslipidemia had lower leucocyte (P < 0.001) and neutrophil (P = 0.001) counts, NLR (P = 0.008), LMR (P = 0.006), and SII (P = 0.049). The MCV was inversely associated with low HDL-C (adjusted prevalence ratio (aPR) = 0.97, 95% CI 0.94–0.99, P = 0.023) but was positively associated with hypertriglyceridemia (aPR = 1.04, 95% CI 1.00-1.08, P = 0.052).ConclusionsIndividuals with dyslipidemia exhibited elevated lymphocyte, monocyte, and platelet counts compared to those without. However, only MCV demonstrated an independent association with specific components of dyslipidemia. There is need for further scientific inquiry into the potential impact of dyslipidemia on red cell morphology and a pro-thrombotic state among patients with TB.

Pemberian SABU (Serum Anti-Bisa Ular) untuk Kasus Gigitan Ular Awitan Lama dengan Komplikasi Disseminated Intravascular Coagulation (DIC)

Background: Snakebite is a neglected disease in subtropical and tropical countries in Asia, Africa, and Latin America. Snakebite is one of the most common venomous animal bites in the world. Case: A 34-year-old male presented with a history of snakebite two days before with a swollen left gluteus and spontaneous gum bleeding. At the emergency room, the patient was fully conscious with blood pressure of 120/80 mmHg, temperature of 36.8oC, pulse rate of 80 beats per minute, and respiration rate of 18 times per minute. Blood studies showed prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), leucocytosis, thrombocytopenia, low hemoglobin, and elevated renal function test. The patient's condition was improved after administration of anti-snake venom, vitamin K injection, transfusion of fresh frozen plasma and packed red cells. He was discharged after three days of hospital stays. Conclusion: Antivenom is the only specific antidote to snake venom; in Indonesia, there is only one local antivenom, commonly known as SABU (serum anti-bisa ular). Inappropriate use of antivenom should be strongly discouraged. Administration of the antivenom should be accompanied by preparedness for anaphylaxis risk.