Sixth Position Research Articles

Epidemiological and clinical presentation of head and neck neoplasia: a review

Head and neck squamous cell carcinoma (HNSCC) stand at the sixth position most, amongst all the malignancies worldwide. Neoplasms arising in the oral cavity, larynx, pharynx, salivary gland and nasal cavity are all included in the head and neck malignancies. More than 90% of malignancies of the oral cavity are squamous cell carcinomas (SCC). Among the four head neck cancer sub-sites combined, the mean age at the time of diagnosis has risen, in the last four decades. Studies have documented a male predilection. A small percentage of SCC cases are inherited or are familial. Cigarette smoking, alcohol consumption, betel quid chewing, poor nutrition, poor oral hygiene, HPV, Epstein-Barr virus and Candida albicans infections are the etiological agents who have the ability to cause HNSCC. Non healing ulcer, difficulty in swallowing, change in voice, swelling, sore throat- that doesn’t get better- are the symptoms of head and neck cancers. Moreover, there may be unusual bleeding, facial swelling or difficulty in breathing.

Biodiversity and Indigenous Medicinal Knowledge of North-East India: Navigating Climate Change Impacts on Medicinal Plants for Conservation and Advancement -

The northeastern region of India holds the sixth position among the world's 25 biodiversity hotspots, covering approximately 8% of the nation's total land area, which amounts to 262,060 square kilometers. Situated in the eastern Himalayas, any alterations in this biodiversity-rich area can have significant and far-reaching consequences. Indigenous tribes of this region believe in the remarkable healing properties of certain medicinal plants, and within its diverse population of around 225 communities, each tribal and sub-tribal group possesses distinct traditional knowledge. Capturing and harnessing this indigenous wisdom by scientists and researchers could unlock new avenues for progress, particularly within the pharmaceutical sector. Climate change stands as one of the paramount global environmental challenges. Predictions indicate that by the close of the 21st century, the Earth's average temperature might rise by anywhere between 0.3 to 4.8 °C, accompanied by a potential sea level increase of 26 to 82 cm. These climate shifts could have adverse effects on the abundance and accessibility of medicinal plants, potentially leading to species extinction. Moreover, the impact of climate change could extend beyond availability to also encompass alterations in the pharmacological properties of various plants, particularly those found in alpine environments. This discussion underscores the importance of existing knowledge, critical analyses, challenges, opportunities, and the immense value of medicinal plants. It emphasizes the intersection of changing climate and the vulnerability of medicinal plant resources, necessitating a comprehensive understanding of these effects in the context of the North Eastern region of India. To address these challenges, there is a pressing need for in-depth research on the geographical distribution of plant communities and strategies to enhance the secondary synthesis of critically endangered medicinal plants under the current climate change scenarios.

Theoretical investigation of substitution effect on the sixth and seventh positions of coumarin derivatives

The linear and non-linear optical properties of 6-donor and 7-donor substituted coumarins were compared using density functional theory (DFT) and time-dependent-DFT (TD-DFT). Charge transfer characteristics were investigated through natural bond order analysis, frontier molecular orbital, and molecular electrostatic potential plots. TD-DFT results suggested that the 6-donor substituted coumarins (PS1, PS3, and PS5) showed red-shifted absorption than the 7-donor substituted coumarins (PS2, PS4, and PS6). The chemical potential (μ) and electrophilicity index (ω) showed direct relation with the band gap and an inverse relation with chemical hardness (η) and hyperhardness (Γ). The global reactivity descriptors μ and ω showed direct and η and Γ showed an inverse correlation with first-order hyperpolarizability (β0) and second-order hyperpolarizability (γ). The β0 and γ for 7-donor substituted coumarin are higher than for 6-donor substituted coumarin.

Emerging Roles for DNA 6mA and RNA m6A Methylation in Mammalian Genome.

Epigenetic methylation has been shown to play an important role in transcriptional regulation and disease pathogenesis. Recent advancements in detection techniques have identified DNA N6-methyldeoxyadenosine (6mA) and RNA N6-methyladenosine (m6A) as methylation modifications at the sixth position of adenine in DNA and RNA, respectively. While the distributions and functions of 6mA and m6A have been extensively studied in prokaryotes, their roles in the mammalian brain, where they are enriched, are still not fully understood. In this review, we provide a comprehensive summary of the current research progress on 6mA and m6A, as well as their associated writers, erasers, and readers at both DNA and RNA levels. Specifically, we focus on the potential roles of 6mA and m6A in the fundamental biological pathways of the mammalian genome and highlight the significant regulatory functions of 6mA in neurodegenerative diseases.

Nitric oxide binding to ferrous nitrobindins: A computer simulation investigation

Nitrobindins (Nbs) represent an evolutionary conserved all-β-barrel heme-proteins displaying a highly solvent-exposed heme-Fe(III) atom, coordinated by a proximal His residue. Interestingly, even if the distal side is exposed to the solvent, the value of the second order rate constants for ligand binding to the ferrous derivative is almost one order of magnitude lower than those reported for myoglobins (Mbs). Noteworthy, nitric oxide binding to the sixth coordination position of the heme-Fe(II)-atom causes the cleavage or the severe weakening of the proximal His-Fe(II) bond. Here, we provide a computer simulation investigation to shed light on the molecular basis of ligand binding kinetics, by dissecting the ligand binding process into the ligand migration and the bond formation steps. Classical molecular dynamics simulations were performed employing a steered molecular dynamics approach and the Jarzinski equality to obtain ligand migration free energy profiles. The formation of the heme-Fe(II)-NO bond took into consideration the iron atom displacement from the heme plane. The ligand migration is almost unhindered, and the low rate constant for NO binding is due to the large displacement of the Fe(II) atom with respect to the heme plane responsible for the barrier for the Fe(II)-NO bond formation. In addition, we investigated the weakening and breaking of the proximal His-Fe(II) bond, observed experimentally upon NO binding, by means of a combination of classical molecular dynamics simulations and quantum–classical (QM-MM) optimizations. In both human and M. tuberculosis Nbs, a stable alternative conformation of the proximal His residue interacting with a network of water molecules was observed.

Lipid mediators in the regulation of innate and adaptive immunity.

Lipid mediators in the regulation of innate and adaptive immunity.

Successful extirpation of a perforated esophagus after chemo radiotherapy in infiltrative ulcerative squamous cell carcinoma

Esophageal cancer is one of the most aggressive malignant neoplasms of the gastrointestinal tract, occupying the eighth place in the structure of morbidity worldwide. Despite comprehensive approaches to treatment, mortality continues to grow in both gender groups, which moves this pathology to the sixth position in the structure of mortality from malignant tumors. A lot of patients undergo radiation therapy in the preoperative period or in an independent version due to the peculiarities of the localization of the tumor or the spread of the process. One of the serious complications of the disease on the background of ongoing conservative therapy is perforation of the esophagus, which, according to the literature, can develop from 5.6 to 33 % of cases, and the risk factors for the development of this complication are infiltrative-u lcerative form of cancer, disease stage T3–4 and the presence of esophageal stenosis, as well as the use of chemotherapy drugs such as fluorouracil and cisplatin. The article describes a clinical case of esophageal perforation in a patient with infiltrative-u lcerative form of squamous cell carcinoma of the esophagus on the background of preoperative chemoradiotherapy. The total focal dose (TFD) at the time of complication development was 24 Gy. As a result of a comprehensive additional examination, which revealed a developed complication in the form of perforation of the esophagus, an interdisciplinary council decided on an immediate surgical intervention, during which extirpation of the esophagus with gastro- and esophagostomy was performed. The patient was discharged on the 15th day in a satisfactory condition with a recommendation to conduct an IHC study for the presence of PD-L1 expression to determine further management tactics. This clinical case demonstrates the role of the infiltrative- ulcerative form of tumor growth, the stage of the disease, as well as the use of chemotherapy drugs during radiation treatment as risk factors for the development of esophageal perforation; an important task at the prehospital stage in the selection of such patients is a thorough examination in specialized oncological centers to exclude possible complications in the process of the above conservative treatment.

Synthesis, characterization and structure-mesomorphic properties relationship of palm-based azo-ester bridged liquid crystals from caprylic acid

This paper discussed the liquid crystal properties of a new homologous series derived from palm caprylic acid that differ in terms of terminal substituents. The chemical structures of synthesized compounds were characterized by nuclear magnetic resonance (NMR), fourier transform infrared (FT-IR) and CHN elemental analysis, while the mesomorphic behaviors were evaluated by polarized optical microscopy (POM) and differential scanning calorimetry (DSC). The insertion of a polar substituent i.e. -CH3 (BME), -OCH3 (BMO), -OCH2CH3 (BEO) at the sixth position on the benzothiazole ring was able to reveal broad nematogenic temperature ranges (65.60–141.48 °C). The nematic mesophase stability is in order of BEO > BMO > BME, with two of them revealing their mesophase characteristics at nearly room temperature. This finding endorses a strong association between polarity factor and mesomorphism which was confirmed through density function theory with the basis set of 6–311 G d,p. The molecules also exhibit relatively high thermal stability (218–312 °C). This finding might be helpful in future structure design of palm-based LCs, as well as encourage the efforts in utilizing palm oil as a renewable and cheaper resource alternative, particularly in non-edible areas such as oleochemical-related research and development.

Synthesis and characterization of two potential impurities (des-ethyl-Ganirelix) generated in the Ganirelix manufacturing process.

Controlling certain diseases using peptide drugs has remarkably increased in the past two decades. In this regard, a generic formulation is an upfront solution to fulfill market demands. Ganirelix, a leading peptide active pharmaceutical ingredient (API) primarily used as a gonadotropin-releasing hormone antagonist (GnRH), has established a potential market value worldwide. But its generic formulation mandates detailed impurity profiles from a synthetic source and contemplates the sameness of a reference-listed drug (RLD). Post-chemical synthesis and processing of Ganirelix, some commercial sources have revealed two new potential impurities among many known, which show the deletion of an ethyl group from the hArg(Et)2 residue at the sixth and eighth positions, named des-ethyl-Ganirelix. These impurities are unprecedented in traditional peptide chemistry, and such monoethylated-hArg building blocks are not easily accessible commercially to synthesize these two impurities. Here, we have outlined the synthesis, purification, and enantiomeric purity characterization of the amino acids and their incorporation in the Ganirelix peptide sequence to synthesize these potential peptide impurities. This methodology will enable the convenient synthesis of side-chain substituted Arg and hArg derivatives in peptide drug discovery platforms.

Abstract 1349: Exploring CD63 as a targetable mediator of the pro-tumorigenic tissue microenvironment in HNSCC

Abstract Introduction: Head and neck squamous cell carcinoma (HNSCC) is one of the ten most common cancer types worldwide - ranked on the sixth position with 560,000 new diagnoses and 270,000 deaths in 2020. The survival could be increased only slightly over the past decades and in addition the incidence of HNSCC continues to rise. In this study, we investigated the role of the tetraspanin CD63 during cancer progression. Methods: First, we performed survival analyses with available statistics from data bases to correlate CD63 and survival. Then, we established a 20-marker spectral FACS panel to identify different fibroblast subpopulations in patient tissue. Upon receiving patient consent, fresh HNSCC tissue was received from surgical tumor resections at the University Hospital of Bonn. We mechanically and enzymatically digested and purified the tissue of ten patients to create single-cell suspensions. After staining, the cells were measured on a Sony ID7000 Spectral Analyzer and interpreted with FlowJo. To identify whether CD63 on fibroblasts affects the differentiation of macrophages in vitro, we isolated primary fibroblasts and monocytes from HNSCC patients and deleted CD63 in fibroblasts by CRISPR-Cas9. Thereafter, we co-incubated fibroblasts (without and with the CD63-Knockout) and macrophages over ten days in M-CSF containing medium, and measured the expression of M1 and M2 markers through flow cytometry. Results: First, correlating CD63 gene expression with the patient outcome showed that CD63 correlated with a decreased survival. Then, analyzing fresh tumor specimens with the multicolor panel showed an increase of CD63 expression in different fibroblast subpopulations in the tumor specimens, e. g. CD9+ CD34+ CD63+ CD90+ fibroblasts increased more than eightfold. Investigating potential mechanisms, by which CD63 expression on fibroblasts affects tumor progression, deleting CD63 steered macrophages towards the pro-inflammatory M1 phenotype. Conclusion: This study demonstrates that HNSCC increases CD63 expression in different fibroblast populations and that deleting CD63 on fibroblasts can steer macrophages towards the pro-inflammatory phenotype, thereby suggesting a rationale for testing CD63 as a therapeutic target. Citation Format: Elisabeth B. Dingendorf, Michael C. Stoffel, Dahlia L. Kittel, Glen Kristiansen, Tristan Lerbs. Exploring CD63 as a targetable mediator of the pro-tumorigenic tissue microenvironment in HNSCC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1349.

Progress of CRISPR/Cas9 in the treatment of sickle cell disease

Sickle cell disease (SCD) is a hereditary monogenic disease, which is characterized by the substitution of glutamic acid at the sixth position of β-peptide chain by valine, resulting in insufficient hemoglobin synthesis and a serious threats to human health. SCD causes about 80% of mortality and morbidity worldwide. Patients with SCD who are homozygous usually die before the age of 30. Patients with SCD who are heterozygous usually have a better prognosis because of their low intraerythrocytic hemoglobin S. However, FDA-approved drugs such as hydroxyurea and L-glutamine can reduce the severity of the disease, and there is no definite cure for all patients with SCD. At this stage, many scholars use creation and correction methods to induce pluripotent stem cells (IPSCs) to treat sickle cell disease. Gene editing is currently considered to be one of the most potential methods for the treatment of SCD. Among them CRISPR/Cas9 gene editing engineering technology has already made an abyss contribution to the transformation of genome engineering and its application in clinical or medical experiments. This review systematically introduces the gene therapy of CRISPR/Cas9, and summarizes the challenges and prospects of this technique in the treatment of sickle cell anemia.

Assessing Countries’ Deceased Organ Donation and Transplantation Performance

Introduction: Donors per million population and transplantations per million population are standardized, widely used indicators to assess and compare countries’ performance in organ donation and transplantation. This study aims to investigate these two particular metrics of organ donation and transplantation performance, and to introduce a new index, namely, ‘transplantations per patients on the waiting list’. Methods: Secondary analyses of data on 23 countries in 2016 were used to construct the transplantations per patients on the waiting list indicator for kidney, liver, pancreas, heart, and lung transplantation, as well as for the transplantation of any of the five aforementioned organs. Results: According to the transplantations per patients on the waiting list, the best-performing countries in terms of organ donation and transplantation are Belarus for kidney transplantation, Finland for liver and pancreas transplantation, Australia for heart transplantation, and France for lung transplantation. Considering all five organs together, Sweden, Australia, Finland, Austria, and Poland were the top five best-performing countries, followed by Spain in the sixth position. Conclusion: The deceased transplantations per patients on the waiting list can be an alternative indicator to assess performance, along with the widely-used donors and transplantations per million population, but still has its limitations in certain scenarios.

A Study on Mushroom Production in India and Odisha Vis a Vis Global Level

In the 21st century, mushroom is seen as the favoured alternate source of food that would help compensate scarcity of nutritious food as mushroom is grown indoors using vertical space and more specifically address the issues of environment sustainability due to recycling of farm wastes. Mushrooms which were earlier found in the forest and forest areas have now been the most prolific and versatile agricultural and horticultural venture. The current study has been undertaken to study the comparative trends in mushroom growth in Odisha, India and world. China is the leading mushroom producer in the world with a lion share of ninety three per cent while India ranks at sixth position with a contribution of slightly more than half a per cent. Odisha, Bihar, Maharastra contribute nearly one third mushroom production in India. In Odisha four districts i.e., Puri, Ganjam, Khurda, Dhenkanal contribute sixty per cent of total mushroom production in the state. The study indicated that the (Compounded Annual Growth Rate) CAGR of world, India and Odisha in mushroom production from 2013-2022 is three, thirty six and sixteen per cent respectively Rajasthan is witnessing a new dawn in mushroom production as it contributed only one per cent with 1300 tons in 2018, is now contributing five per cent with 15000 tons in 2022 with a CAGR of sixty six per cent. Even if with the favourable climatic condition, production of mushroom in the north eastern states of India is negligible. The button mushroom which is the highest contributor in India with seventy three percent contributes only eleven per cent in the world level and one per cent in Odisha. Similarly paddy straw mushroom that contributes almost sixty six per cent in Odisha has a meagre contribution of only one per cent in the global level and seven per cent in India. Oyster mushroom has a uniform share of twenty six per cent in the world, sixteen per cent in India and thirty three per cent in Odisha. It may be estimated that if the current growth rate continues then in the next five years by 2027 the world mushroom production will be around fifty million tons, while the mushroom production in India and Odisha would stand at around six lakhs tons and sixty five thousand tons respectively.

DIRECTIVE ACTS IN INTERNATIONAL LEGAL DISCOURSE: SCALE OF ILLOCUTIONARY FORCE INTENSITY

The article introduces an eight-component taxonomy of directives in international legal discourse, depending on the degree of illocutionary force, based on the criteria of illocutionary markers, directive force mitigators and modifications of the prototypical structure of directives. The research integrates the methods of speech act analysis, tools of the theory of mitigation and discourse analysis. An eight-point degree of intensity distinguishes directives with the verbs "shall" and "must" to indicate obligations in the performative part of the prototypical structure of directives. The seventh-point degree is marked by “should” to designate recommendation. Explicit directives extended with hedges specifying possibilities of the norm adaptation in favor of the capabilities of states fall under the sixth position. The fifth degree of intensity is typical for acts marked with adjectives indicating the urgency of action. The fourth position on the scale of deintensification pertains to directives with obligative verbs in the passive construction of the propositional component, with the performative component being omitted. Directives occupying the third position on the scale of illocutionary force intensity are marked, in addition to the omitted performative component, with hedges that allow for deviation from the norm in application. A two-point degree of intensity distinguishes acts with an omitted performative component in which the position of the phrasal subject is taken by nominations of the object of obligations, instead of legal subjects. Directives with an omitted performative component, where the legal subject is replaced by the designation of the object of the directive action and the performative verb is replaced by an indirect marker of obligation, occupy the first position in terms of de-intensified illocutionary force level.

Analysis of penetration and density of the Indian insurance industry

At present, India’s insurance industry rank tenth in the world and it is expected that by the end of the year 2032, the insurance industry will attain the sixth position in the world. Analysis of insurance density and penetration is essential to assess the progress of insurance business of any country. The present study is based on secondary data and the data was collected from the annual reports of IRDAI. For the purpose of analysis three groups were made of the selected companies. First group represented the Insurance Industry, the second group was life insurers and the third was made of non-life insurance companies. Growth and trend analysis of twenty one years from 2001-02 to 2021-22 had been done to compare the growth of the selected companies. Further, to test the validity of the hypothesis, ANOVA has been used on SPSS. The study revealed the significant difference in the mean score of all three groups. During the research, it was found that the density and penetration both have significantly increased.

Synthesis, characterization and antibacterial evaluation of N‐(2‐Morpholinoethyl)‐3‐phenylquinoxalin‐2‐amine derivatives

AbstractA series of substituted N‐(2‐Morpholinoethyl)‐3‐phenylquinoxalin‐2‐amines (5a–j) (5ab, 5ac) were synthesized in good yield and characterized for their structural confirmation. The pure quinoxaline products were screened for their in‐vitro antibacterial activity against Salmonella paratyphi, a well‐known food borne pathogen. The preliminary results revealed that among the series, compounds 5a, 5c, 5d, 5e, 5f, 5h, 5ab and 5ac bearing bromo, fluoro, methoxy, methyl groups at para position on phenyl ring which inturn substituted at third position of quinoxaline and methyl, benzoyl groups at sixth position on the quinoxaline were emerged as potential candidates by displaying antisalmonella activity. Among the potential candidates, compounds 5c, 5e, 5f and 5ac were effective against Salmonella whereas compounds 5a, 5f and 5ac effectively inhibited the biofilm formation of Salmonella.

A novel, conserved and possibly functional motif “WHWGHTW” in mitochondrial transcription across Bilateria

The animal mitogenomes which undergone a reductive evolution has an obvious loss of coding capacity compared to their known closest relatives, but it has not yet been fully investigated why and how the intergenic regions do not encode protein and have no known functions, are stably maintained, replicated, and transmitted by the genome. These relatively small intergenic regions may not be under neutral evolution and they may have functional and/or regulatory roles that have yet to be identified. Here, the distribution pattern, sequence content and location of a novel sequence motif of ‘WWWGHTW’ were bioinformatically investigated and characterised by constructing a sampling mitogenome dataset of 1889 species from 14 phyla representing the clade of Bilateria. This motif is reverse complementary of the previously described DmTTF binding sequence and found in the nd4L- (X) -trnT gene cluster. This cluster commonly exhibits a strand displacement region and an intergenic region among the bilaterian superphylums, particularly in Ecdysozoa. This motif may be accepted as a substrate providing binding sites for the specific interaction with transcription factors because of (i) its reverse complementarity of previously described DmTTF binding sequence, and (ii) the possession of G and T nucleotides in the fourth and sixth positions, (iii) the bias on T and G nucleotides instead of C and A in the degenerated positions. This suggestion is also supported by the presence of a strand displacement region in the nd4L- (X) -trnT gene cluster, particularly in Ecdysozoa consisting of the most rearranged mitogenomes among the bilaterian superphylums.

USING THE INDONESIAN MANCHESTER CLINICAL PLACEMENT INDEX (I-MCPI) TO ASSESS THE QUALITY OF HOSPITAL-BASED AND COMMUNITY-BASED CLINICAL LEARNING ENVIRONMENT

Background: Clinical placement is crucial to develop the fundamental competencies in providing patient care. Therefore, clinical learning environment (CLE) assessment is necessary to ensure its quality. The Indonesian Manchester Clinical Placement Index (I-MCPI) is an instrument for assessing the quality of the learning environment and the quality of training in both hospital and community placements. This study aimed to (1) measure the CLE quality of a school of medicine in Jakarta using I-MCPI and (2) explore the qualitative data resulted from the I-MCPI to draw a comprehensive conclusion about CLE.Methods: 155 respondents filled the online I-MCPI, and ten respondents participated in the in-depth interviews. The quantitative data were analyzed using the guideline provided by the original MCPI. The qualitative data analysis was performed using content analysis method.Results: Quantitative data resulted in ranks of the 18 clinical placements, including primary teaching hospital and its network clinical placements. Trends in Primary Health Care (PHC) placement showed lower rank on the CLE and the training quality. The primary teaching hospital was in the sixth position. The qualitative results identified issues of the supervisor’s role, students’ involvement, and learning facilities were identified as significant factors that influenced CLE.Conclusion: Most respondents were satisfied with the quality of learning in clinical rotation at the school. However, respondents suggested more support for students to be actively involved in clinical services, perform clinical skills, and encourage learning facilities to optimize the CLE.

Oropharyngeal cancer: a clinical case report

Introduction: The National Cancer Institute (INCA) estimates that for each year of the triennium 2020/2022, 15,190 new cases of cancer in the mouth and oropharynx are diagnosed in Brazil. In the global context, oropharyngeal cancer (OPC) is in the sixth position of cancer incidence. The most frequent form, about 90%, is squamous cell carcinomas. Objective: It was to present a clinical case report of oropharyngeal cancer in an octogenarian patient, to present the main diagnostic and treatment procedures in advanced age. Methods: The present study was elaborated according to the rules of the CARE case report. Scientific search engines: PubMed, Embase, Scopus, Google Scholar, Scientific Electronic Library Online (Scielo), published in Portuguese in the last 10 years. Case report and Conclusion: Based on the objective of this study and the literary findings, it showed that knowledge about OPC is essential for dental professionals, which plays a fundamental role in the diagnosis of oral cancers, requiring incisional biopsy. From the case described, it became evident the need for a partnership with a licensed psychologist, for the psychological preparation of the patient who will receive the news of the positive result for oropharyngeal cancer and the follow-up of the same throughout the treatment.

Hematological parameters levels study in sickle cell anemia patients in Al-Diwaniyah and Al-Najaf governorates

Background: Sickle cell anemia a dangerous genetic disorder in which the erythrocytes of the body caused by a mutation in the HBB gene in the sixth position of the β chain, there is a change in the composition of hemoglobin due to the presence of sickle hemoglobin (Hbs). Aim of the study: Is to evaluate the hematological parameters levels in sickle cell anemia condition of patients with sickle cell anemia in the governorates Al- Diwaniyah and Al-Najaf Al-Ashraf. Methods: A total of one hundred and twenty-four subjects were recruited for this study which consists of eighty four sickle cell anemia subjects who (48 males and 36 females) and Forty healthy (20 male and 20 female) subjects as control who matched by age and sex of the patients groups. Conclusion: The outcomes indicated decrease in the level of RBC, Hb, MPV and HCT, while observed increased in the level of WBC, PLT, RDW-SD, RDW-CD, MCV, MCHC and PDW in sickle cell anemia patients compared with the control groups, however observed no significant in level of MCH in sickled patients compared with the control groups.