Hb Values Research Articles

What is the best treatment for anemia in pregnant women in the third trimester: Ferric carboxymaltose or oral iron therapy?

Objective: Iron deficiency anemia (IDA) is a significant health problem in pregnant women. We aimed to evaluate the effect of gestational IDA and to compare the results of iron therapy in pregnant women. Methods: This retrospective cohort study of pregnant women in the third trimester analyzed the records of 63 women not taking any iron supplements, 70 women receiving intravenous ferric carboxymaltose therapy (FCM), and 73 pregnant women receiving oral iron therapy. It compared maternal and neonatal outcomes of the three groups. Results: The mean age of the 206 pregnant women included in the study was 29.19±4.34 (19-44; min–max). Only 1% of anemic women received a blood transfusion in the postpartum period. There was no difference between the groups' mean age and gestational week. The median values of gravida and parity were the same in all 3 groups (Gravida=2, Parity=1). Maternal hemoglobin (Hb) value of the non-iron group was lower than that of the other groups (p<0.001). Although the mothers' Hb levels at birth were different, the newborns' Hb values were not affected (p=0.547). Neonatal height and weight were lower in the non-iron group than in the FCM and oral iron groups (p=0.048 and p<0.001, respectively). Neonatal head circumference, 1-minute Apgar, and 5-minute Apgar scores were similar in all three groups. Conclusion: FCM is effective in pregnant women with IDA in late pregnancy and women undergoing this treatment deliver healthier newborns.

The role of inflammation in children with specific learning disorders

Background: Specific learning disorder (SLD) is a common neurodevelopmental disorder in childhood with a delay in reading, writing, and/or mathematics. The etiology of SLD is not known exactly. Aim: In our study, we aimed to evaluate the effect of inflammation in the etiology of SLD. Materials and Methods: In our study, patients aged 7–14 years who applied to the child psychiatry outpatient clinic between November 2019 and November 2020 were retrospectively screened. The hemoglobin (Hb), red cell distribution width (RDW), platelet (PLT), plateletcrit (PCT), platelet distribution width (PDW), and white blood cell (WBC) values of the children were recorded. Neutrophil/lymphocyte ratio (NLR) and PLR values were calculated. Comparisons were carried out on different variables using SPSS version 22. Results: There was no significant difference in terms of age and gender in the SLD and control groups. When blood parameters were evaluated, there was no significant difference between the groups in terms of Hb, RDW, PCT, PDW, and WBC values. The PLT count was significantly higher in the patient group than in the control group (P = 0.049). There was no significant difference between the groups in terms of TLR and NLR values. Conclusion: The results of our study showed that Hb, RDW, PCT, PDW, WBC, NLR, and TLR values were similar in SLD and healthy control groups. This does not support the hypothesis that an increased inflammatory response may be responsible for the etiology of SLD. Considering the heterogeneity in the clinical symptoms and etiopathogenesis of SLD, more extensive studies are needed in this area.

Deep Learning Based Walking Tasks Classification in Older Adults Using fNIRS.

Decline in gait features is common in older adults and an indicator of increased risk of disability, morbidity, and mortality. Under dual task walking (DTW) conditions, further degradation in the performance of both the gait and the secondary cognitive task were found in older adults which were significantly correlated to falls history. Cortical control of gait, specifically in the pre-frontal cortex (PFC) as measured by functional near infrared spectroscopy (fNIRS), during DTW in older adults has recently been studied. However, the automatic classification of differences in cognitive activations under single and dual task gait conditions has not been extensively studied yet. In this paper, by considering single task walking (STW) as a lower attentional walking state and DTW as a higher attentional walking state, we aimed to formulate this as an automatic detection of low and high attentional walking states and leverage deep learning methods to perform their classification. We conduct analysis on the data samples which reveals the characteristics on the difference between HbO2 and Hb values that are subsequently used as additional features. We perform feature engineering to formulate the fNIRS features as a 3-channel image and apply various image processing techniques for data augmentation to enhance the performance of deep learning models. Experimental results show that pre-trained deep learning models that are fine-tuned using the collected fNIRS dataset together with gender and cognitive status information can achieve around 81% classification accuracy which is about 10% higher than the traditional machine learning algorithms. We present additional sensitivity metrics such as confusion matrix, precision and F1 score, as well as accuracy on two-way classification between condition pairings. We further performed an extensive ablation study to evaluate factors such as the voxel locations, channels of input images, zero-paddings and pre-training of deep learning model on their contribution or impact to the classification task. Results showed that using pre-trained model, all the voxel locations, and HbO2 - Hb as the third channel of the input image can achieve the best classification accuracy.

The utero-tonic effects of low dose intravenous ketamine in cesarean section under spinal anesthesia; A randomized double-blind clinical trial.

Recently, the prevalence of cesarean section (CS) has been on the rise and the proper uterine tone is an important issue. We investigated the effects of intravenous (IV) ketamine on intraoperative bleeding and the need for oxytocin in CS under spinal anesthesia (SA). This study, took place at Alzahra hospital during 2020. Pregnant women candidate for elective CS under SA were divided into two groups of ketamine and placebo. In group K, after umbilical cord clamping, 0.25 mg/kg ketamine and in group P 2ccs normal saline was injected. Mean arterial pressure and heart rate were recorded at baseline, before and 5 minutes after cord clamping and at the end of the surgery. The drop in hemoglobin values, the administrated units of oxytocin and side effects were also recorded. No significant difference was found in terms of patients' demographic data (P ≥ 0.05). The mean units of administrated oxytocin in group K was 34.61±6.63 and in group P; 48.47±12.15, which was significantly different (P=0.0001). The drop in Hb was less in group K, however not statistically significant (P=0.094). The need for methergine was significantly higher in group P (P=0.0001). The mean HR was significantly higher in group P (P=0.027), however, no significant difference was observed regarding the MAP (P=0.064). The incidence of hallucination (4.8%) and nystagmus (21%) was significantly higher in group K (P= 0.0001), but nausea and vomiting were more significant in group P (P= 0.027). Prophylactic administration of low-dose ketamine in CS under S.A could significantly reduce the administrated oxytocin units and the need for additional utero-tonics and was associated with less drop in Hb values.

Hemoglobin and End-Organ Damage in Individuals with Sickle Cell Disease

Sickle cell disease (SCD) is an inherited, chronic, multifaceted blood disorder. Patients with SCD develop anemia, which has been associated with end-organ damage (EOD). This retrospective, observational, repeated-measures study systematically characterizes the relationship between hemoglobin (Hb) level and EOD in adolescent and adult patients with SCD. The study population comprised patients with SCD aged ≥12years with available Hb data from a US provider-centric health care database. For each patient, each Hb value over time was included as a separate observation. Study outcomes-the onset of any new EOD, including chronic kidney disease, pulmonary hypertension, stroke, and leg ulcer-were ascertained during the 1-year period after each Hb assessment. The association between Hb levels and risk of new EOD was estimated using multivariable generalized estimating equations. A total of 16,043 unique patients with SCD contributed 44,913 observations. Adjusted odds of any EOD during the 1-year follow-up were significantly lower with higher Hb level. Risk reductions with higher Hb levels for chronic kidney disease, pulmonary hypertension, and leg ulcer were comparable. The risk of new EOD was significantly lower among adolescent and adult patients with higher Hb levels. In patients with SCD, higher Hb levels are associated with a reduced risk of developing EOD. Therapeutic strategies that result in higher Hb levels may offer clinical and economic value for patients with SCD. (Curr Ther Res Clin Exp. 2023; 84:XXX-XXX).

Comparison of the blood gas analyser Edan i15 Vet with the blood gas analyser Gem Premier 3000 for the analysis of blood gases, electrolytes, hemoglobin and hematocrit in lactating Holstein

A point-of-care blood gas analyser, Edan i15 Vet (EDAN), was compared with a benchtop blood gas analyser, GEM Premier 3000 (GEM). GEM and EDAN were used to analyse whole blood from 123 lactating Holsteins within one month of calving for blood gases, electrolytes, hematocrit and hemoglobin. EDAN and GEM showed significant linear correlations for blood gases, electrolytes, Hct and Hb. The 95% confidence intervals (CI) of intercept in Passing-Bablok regressions included zero in pCO2, bicarbonate, TCO2, BE ecf, BE B, hematocrit, and pH, but not for Na+, K+, pO2 and sO2. The CI of the slope included 1.0 for Na+, K+, pCO2, bicarbonate, TCO2, BE ecf, BE B, hematocrit, and pH, but not for pO2, sO2, and hemoglobin. The Bland-Altman plots between EDAN and GEM showed a bias of 1.4% for Na+, 2.4% for K+, –1.6% for pCO2, 3.0% for pO2, –5.3% for bicarbonate, 2.8% for SO2, –7.3% for TCO2, 10.4% for Hct, 21.2% for Hb, –25.1% for BE B and –38.5% for BE ecf. The biases in the analysis of certain estimated parameters were much higher (> 5%) than for measured parameters except for Hct. Parity did not correlate with blood gas parameters but blood pH correlated negatively with K+, pCO2 and positively with pO2, TCO2, sO2, bicarbonate, BE ecf and BE B. The postpartum time correlated positively with pCO2, TCO2, BE and bicarbonate and negatively with Hct and Hb values. Reference values (2.5-97.5% quartiles) were determined for each parameter. Conclusively, EDAN can be used interchangeably with GEM for the analysis of blood pH, K+, pCO2 and HCO3 – as they show acceptable moderate agreement. However, they did not agree for other parameters such as TCO2, BE ecf, BE B, Hb, Hct, sO2, Na+, and pO2, therefore, reference values for each parameter were set for GEM and EDAN.

Effects of Different Hemoglobin Levels on Near-Infrared Spectroscopy-Derived Cerebral Oxygen Saturation in Elderly Patients Undergoing Noncardiac Surgery

Background: Near-infrared spectroscopy (NIRS) is a commonly used technique to evaluate tissue oxygenation and prevent harmful cerebral desaturation in the perioperative setting. The aims of the present study were to assess whether surgery-related anemia can be detected via NIRS of cerebral oxygen saturation and to investigate the effects of different perioperative transfusion strategies on cerebral oxygenation, potentially affecting transfusion decision-making. Study Design and Methods: Data from the ongoing multicenter LIBERAL-Trial (liberal transfusion strategy to prevent mortality and anemia-associated ischemic events in elderly noncardiac surgical patients, LIBERAL) were used. In this single-center sub-study, regional cerebral oxygenation saturation (rSO₂) was evaluated by NIRS at baseline, pre-, and post-RBC transfusion. The obtained values were correlated with blood gas analysis-measured Hb concentrations. Results: rSO₂ correlated with Hb decline during surgery (r = 0.35, p < 0.0001). Different RBC transfusion strategies impacted rSO₂ such that higher Hb values resulted in higher rSO₂. Cerebral desaturation occurred at lower Hb values more often. Discussion: Cerebral oxygenation monitoring using NIRS provides noninvasive rapid and continuous information regarding perioperative alterations in Hb concentration without the utilization of patients’ blood for blood sampling. Further investigations are required to demonstrate if cerebral rSO₂ may be included in future individualized transfusion decision strategies.

Screening the Health Status of Postpartum Anoestrus Cows of Biratnagar of Nepal

High yielding dairy cattle are often prone to postpartum anestrus that retards both production and reproductive performances. To investigate the postpartum anestrus, 21 nondescript dairy cows raised in and around Biratnagar have been included in this study. The basic information regarding the breeding history, nutritional status, milk yield, suckling and frequency of milking were obtained on request from the owners. Fecal samples were collected directly from the rectum of all cows to diagnose the parasitic infestations. Rectal palpation was performed to explore the status of the ovary and other reproductive tracts. Blood samples were collected through jugular vein puncture in vials with and without anticoagulant for hematological and serobiochemical analysis. Rectal palpation revealed inactive ovaries in most of the dairy cows. The fecal and blood samples had been forwarded to Regional Veterinary Diagnostic Laboratory, Biratnagar for further analysis. Fecal examination resulted in severe parasitic infestations in 90.47% of dairy cows. The predominantly observed parasites were Paramphistomum (38%) followed by Paramphistomum + Nematodes (19%), Nematodes (9%), Liver fluke + Nematodes (9%), Liver fluke (5%), Liver fluke + Paramphistomum (5%) and Nematodes + Moniezia expansa (5%). Among all, 47.61%, 42.85%, 28.57%, 23.80% and 4.76% of cows revealed lower values for total protein (TP), hemoglobin (Hb), calcium (Ca), packed cell volume (PCV), glucose (Glc) and inorganic phosphorus (P), respectively. However, 23.80% and 9.52% of cows showed higher values of inorganic P and Glc. It was concluded that lower values of TP, Hb, Ca, PCV, Glc and inorganic P rightly held responsible for the condition of postpartum anoestrus in cows. An improved managemental practices and nutritional status of cows is suggested for the management of postpartum anoestrus in cows.

Clinical, hematological, serum biochemical, and acute phase protein indices in pulmonary affected calves

This study was performed on 24 calves aged about 30-100 days old, fourteen calves were suffering from signs of pulmonary affections including fever, bilateral muco-purulent nasal discharge, cough and abnormal lung sounds upon auscultation and these calves were enrolled as pulmonary affected group. The other ten calves were apparently clinically healthy as proved by clinical examination and were used as a control healthy group. Blood and serum samples were collected from healthy and diseased calves (before and after treatment). Hematological analysis of diseased calves before treatment showed a significant decrease in the value of RBCs and Hb, with no significant changes in the value of PCV between healthy and diseased calves before and after treatment. The total leucocytic count showed a significant increase in its value in diseased calves with significant increase in neutrophils and lymphocyte (%) as compared with healthy ones. Serum biochemical analysis of pulmonary affected calves showed hypoproteinemia, hypoalbuminemia, hypoglycemia, hyponatremia, hypochloremia and hyperkalemia as compared with healthy control calves. Activities of serum AST, ALT showed significant elevations in pulmonary affected calves with no significant changes in levels of total and direct bilirubin as compared with healthy calves. Analysis of acute phase protein of diseased calves before treatment showed a significant increase in values of Haptoglobin (Hp), serum amyloid A (SAA), Ceruloplasmin (Cp) and C - reactive protein (CRP) as compared with their levels after treatment and in healthy calves.

Perioperative characteristics and predictors of intensive care needs in patients undergoing surgery for scoliosis: a retrospective study of 165 patients

In this study, we retrospectively performed a review of medical records of all patients who underwent scoliosis surgery between January 2018 and January 2021. A total of 165 patients were included; (64.2% were female and the mean age was 21.6 ± 16.7 years). The most frequent aetiologies of scoliosis were idiopathic, congenital, degenerative and neuromuscular. In 48 patients who required Intensive Care Unit (ICU) stay, the rate of comorbidity was 75% (n = 36); lung disease was present in 54% (n = 26) of cases and restrictive lung disease was present in 47.9% of cases (n = 23), which were significantly higher than those who did not require ICU stay (p &lt; 0.001). The proportion of patients with neuromuscular problems was 45.8% (n = 22) (p = 0.004) while those with epilepsy was 16.7% (n = 8) (p = 0.027). The proportion of patients with neuromuscular scoliosis was 25% (n = 12), the median number of fused vertebrae (fusion level) was 15, and the proportion of American Society of Anaesthesiologists (ASA) III patients was 54.2%(n = 26) (all p &lt; 0.001). The median surgical duration was 307.5 minutes (p = 0.006) and the proportion of patients which received blood transfusion was 91.7% (n = 44) (p = 0.002). The pre- and post-operative haemoglobin (Hb) levels, and the post-operative arteriel blood gases (ABG) potential of hydrogen (pH) and lactate levels of patients, who needed ICU were significantly different from those who did not require the ICU (p = 0.043, p = 0.039, p &lt; 0.001 and p = 0.037). In conclusion, a presence of restrictive lung disease, epilepsy, neuromuscular scoliosis, a high fusion level, a need for blood transfusion, long surgical duration, low Hb and pH values, and high lactate levels were found as the predictors of ICU admission.

Comparison of vaginal, abdominal and laparoscopic hysterectomy performed in our hospital

Hysterectomy is the most common pelvic surgical operation and is often performed for benign reasons. We aimed to compare clinical total abdominal hysterectomy (TAH), total laparoscopic hysterectomy (TLH), and vaginal hysterectomy (VH) in benign gynecological conditions. Patients' age, operation duration (min), length of stay in the hospital (days), Preop Hb (g/dL), Postop Hb (g/dL) values, complications according to the performed surgical procedures were analyzed. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications. it was observed that the patients' ages were significantly higher in the VH group (H=71.721; p=0.000), the operation duration was significantly shorter in the TAH group (H=125.689; p=0.000), and the length of hospital stay was significantly shorter in the TLH group (H=71.492; p=0.000). Preoperative and postoperative hemoglobin values were significantly higher in the VH group (H=57.222; p=0.000, H=52.824; p=0.000). It was determined that the complication rate was lower in the TAH group. The type of surgical procedure was found to not have a statistically significant effect on transfusion requirement (χ2=4.852; p&gt;0.05) and history of previous surgery (χ2=0.115; p&gt;0.05). The surgical approach of hysterectomy plays a significant role in postoperative morbidity. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications.

Comparative study on intravenous iron sucrose versus intravenous ferric carboxymaltose in the management of iron deficiency anaemia in pregnancy in a tertiary care hospital, Bengaluru

Background: Iron deficiency is the most common nutritional deficiency worldwide; it affects 1.6 billion people Iron deficiency (ID) and iron deficiency anemia (IDA) are often encountered in the general population, particularly among children and women with abnormal uterine bleeding (AUB) and during pregnancy as well as postpartum period Intravenous (IV) iron replacement can deliver the total amount of required iron over a short period. Currently, the most commonly used IV iron formulations are iron sucrose (IS) and ferric carboxymaltose (FCM) [4-6]. Iron sucrose does not require test dose and is safe. Ferric carboxymaltose (FCM) is the latest I.V. iron formulation which can be used at high doses and allows rapid administration (up to 1000 mg in a single dose infused in 15 minutes) The present study was a comparative study of parenteral iron therapy (intravenous iron sucrose versus intravenous ferric carboxymaltose in the management of iron deficiency anaemia in pregnancy.Methods: In the present study, 50 pregnant women with IDA were randomly distributed into two groups of 25 each. Group - A: 25 receiving intravenous iron sucrose therapy; Group - B: 25 receiving intravenous ferric carboxymaltose therapy.Results: Majority of the study participants in Group A had gestational age between 20–25 weeks (48%). The mean age of the study participants in Group A was found to be 22.86+4.42 weeks. Majority of the study participants in Group B had gestational age between 20-25 weeks (36%). The mean age of the study participants was found to be 23.01+3.01 weeks. Majority of the study participants in Group A had nil parity (40%). 36% of the study participants in Group B had nil parity. 60% of the study participants in group A had Mild degree of anaemia with 52% in group B having mild degree of anaemia. 40% and 44% of the study participants in group A and group B had Moderate degree of anaemia respectively. The association was found to be statistically significant between the mean Hb and Ferritin values pre-treatment, 3rd and 6th week follow-up post treatment and the 2 groups of study participants. The adverse effects were comparatively lower among Group B (IV ferric carboxymaltose) than Group A (IV iron sucrose) of the study participants.Conclusions: IV ferric carboxymaltose administration increases the hemoglobin level more rapidly as compared to iron sucrose in women with iron deficiency anemia in the pregnancy. It also stores iron more rapidly. No serious adverse effects were recorded. Ferric carboxymaltose is well tolerated, safe and effective alternative to iron sucrose in iron deficiency anemia of pregnancy. FCM has the advantage of a large dose administration per sitting and early rise in hemoglobin level.

Determinants for Anemic Retinopathy.

To study the prevalence of fundus lesions in anaemics and define the hematological risk factors for retinopathy using the receiver operating characteristic curve analysis. For this retrospective study, patients ≥18 years and diagnosed with anemia with dilated fundus examination by a retina specialist from May 2019-April 2020 were included. Anemic retinopathy (AR) was present if hemorrhages in different layers of the retina, Roth's spots, exudates, cotton wool spots, retinal edema, and optic disc changes were noted. Patients with secondary anemia were excluded. Two groups were identified: Group 1: Patients with AR; Group 2: Patients with no AR with normal fundus. Demographic features, fundus findings, and hematological parameters were noted. 38 (30%) eyes of 23 patients had AR; 90 (70%) eyes of 47 patients had no AR. The mean age in Group 1 and Group 2 was 54.7±18.9 and 58.6±15.3 years, respectively. Low hemoglobin (Hb) [mean = 7.82±1.64 gm/dl, p=<0.001] and hematocrit [mean = 26.93±5.22 %, p=0.002] values were noted in the AR group. AUC values for Hb (0.737) and hematocrit (0.719) were higher for the AR group. Hb < 8.95g/dl could predict AR with 85.8% sensitivity and 68.9% specificity, and hematocrit < 30.5% could predict AR with 80% sensitivity and 53.2% specificity. On regression analysis, Hb (p<0.001) and hematocrit (p=0.000) were associated with AR. Retinopathy is frequently seen in severe anemic patients. It is recommended that patients having low anemia should undergo a retinal examination.

Hypertriglyceridemia and its impact on hematological indicators: A study based on Turkish national health database.

The hematocrit (Hct) to hemoglobin (Hb) ratio, generally at 3.0 in healthy individuals, can vary in certain disease states. An emerging area of interest is the potential influence of triglyceride concentrations on this ratio and hemoglobin A1C (HbA1c) levels. This study aimed to identify the changes in HbA1c and the Hct/Hb ratio as triglyceride concentration increases. This research involved an extensive analysis of 35,656,613 laboratory samples taken between January 2015 and December 2022 in Türkiye, including the respective triglyceride, Hb, Hct, and HbA1c results. The laboratory test results were obtained from the national health database of the Turkish Ministry of Health. The triglyceride levels were divided into 24 groups, each incremented by 100 mg/dL from a range of 0-3099 mg/dL. Mean and standard deviation values of Hb and Hct were calculated for each group, and the Hct/Hb ratio was graphically represented. The average HbA1c values ranged between 4.37±0.85 and 7.76±3.19 across the groups, Hb averages ranged from 9.75±1.7 to 14.03±2.21, Hct averages from 27.35±4.97 to 38.86±5.66, and Hct/Hb ratios varied between 2.77 and 3.03. The overall average for all samples was identified as 5.15±0.13 for HbA1c, 38.48±5.13 for Hct, 12.73±1.65 for Hb, and 3.02 for the Hct/Hb ratio. It was observed that the Hct/Hb ratio gradually decreased as triglyceride levels increased. Evaluating anemia based on Hb concentration in individuals with hypertriglyceridemia might be misleading. It is recommended to use a correction factor based on triglyceride level.

The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study.

Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes. We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed. The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients. mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs.

Validity of point-of-care device for diagnosing anemia in workers exposed to lead

Detecting anemia in occupational health settings is critical in a high-risk population for anemia like the lead-exposed. Whether the point-of-care devices are sensitive to detect anemia in individuals with high levels of lead exposure is unknown. We compared hemoglobin (Hb) levels from HemoCue® Hb 301 System and standard analyzer, Mindrey-BC 5300, in individuals (n=58) exposed to lead (mean levels = 44.9 ?g/dL) for a chronic period (mean duration of exposure = 105 months). We observed high sensitivity (0.95), specificity(0.95) in detecting anemia by hemocue, and high agreement between the methods. The significant difference in Hb values between the methods (0.171g/dL, p=0.018) was clinically minimal. We conclude that hemocue is a good method for rapidly detecting anemia and estimating Hb levels among the lead-exposed in resource-limited settings.

Effects of Phototherapy on Hematological Parameters in Newborns with Indirect Hyperbilirubinemia

Introduction: Indirect hyperbilirubinemia is an important problem in newborns and phototherapy has an important role in treatment. The aim of this study is to evaluate the effects of phototherapy on hematological parameters in newborns with indirect hyperbilirubinemia. &#x0D; Method: In the last three months, 60 newborns (term = 30 and preterm = 30) diagnosed and treated for indirect hyperbilirubinemia were included in this study. &#x0D; Results: Twelve of the neonatal terms (40%) had either Rh incompatibility (n = 3) or ABO incompatibility (n = 9), 10 of the preterm newborns (33%) had either Rh incompatibility (n = 3) or ABO incompatibility (n = 7). The median durations of phototherapy of term and preterm newborns were 24 (range, 6-40) and 11 hours (range, 4-36), respectively. After phototherapy, it was found that the counts of WBC and RBC, Hb, MCV and RDW values of term newborns decreased statistically (p values were .0187, .0007, 0001, .0036 and

PECTIN MODULATES HEMATO-BIOCHEMICAL PARAMETER, HISTOPATHOLOGY, OXIDATIVE STRESS BIOMARKERS, CYTOKINES AND EXPRESSION OF HEPCIDN GENE IN LEAD INTOXICATED RATS

Publications concerning the protective effect of pectin against lead induced toxicity in rats are not available. In order to study such effect, 40 male rats were divided into 3 groups. The first group was contained 10 rats that kept as control group. The second group was contained 10 rats that received pectin at dose of 100 mg/kg BW during experimental period (8 weeks). The third group was contained 20 rats that received 400mg/kg BW of lead acetate daily for 4 weeks then divided into two subgroups (3A and 3B). Subgroup 3A contained 10 rats that still receive lead acetate in the same dosage whereas, subgroup B co-treated with lead acetate and pectin daily for another 4 weeks. Blood samples were collected after 2, 4 and 8 weeks from the start of the experiment. Liver, kidney and bone marrows were collected only at the end of the experiment. Lead acetate induced anemia only after 4 weeks of administration as reflected on decreased values of Hb, PCV, MCV, MCH and MCHC. These indices remained at lower levels in lead acetate treated groups until the end of the experiment. Concentrations of serum ferritin, iron, total antioxidant capacity (TAC) and reduced glutathione (GSH) and the expression of hepatic hepcidin gene were decreased significantly in lead acetate intoxicated rats compared to control. Activities of ALT and AST and concentrations of urea, creatinine, Nitric oxide (NO), TNF-α, IL-6, total iron binding capacity (TIBC) and lead were increased significantly in lead acetate intoxicated group compared to control. Hepatic degeneration and hemorrhage, renal lytic necrosis and apoptosis of myeloid cells were most prominent changes in lead intoxicated rats. Lead acetated related changes were improved by co-treatment with pectin however; normal control values have not been achieved. Conclusively, pectin is recommended to protect against lead acetate toxicity in rats. Key words: lead acetate; toxicity; pectin; hepcidin; oxidative stress biomarkers; histopathology

Typhoid Pediatric Inpatient Clinical Symptoms, Laboratory and Antibiotic Treatment

Clinical features of typhoid fever vary from mild to severe. Laboratory examination for typhoid fever in Indonesia still uses the Widal test as a diagnostic tool. In 1992, isolates of S.typhi showed resistance to fluoroquinolones, with the first case reported in the United Kingdom. Similar cases were reported from several other countries, including India. This study aimed to describe the clinical symptoms, laboratory and antibiotics used for children with typhoid hospitalized at Hospital ‘X’ in West Java from January to March 2017. This research was a descriptive retrospective, using a cross-sectional design with a total sample of 127 respondents. The study was conducted from January to March 2018. Patients suffering from typhoid were hospitalized at Hospital ‘X’, West Java, were 37% aged between 5-9 years old with 51.18% males and those whose length of stay was for 3 days was 29.13%. Widal Titer O positive examination was 13.91% and positive H Titer was 45.21%, positive tubex 93.75%, 26.77% leukopenia, 48.81% with Hb value &lt;11.5, the patient had a fever of 99.21%, 85.03% was given ceftriaxone. Clinical symptoms that are often experienced by children with typhoid typhoid is fever and the antibiotics that are often given are ceftriaxone.&#x0D; Keywords: typhoid fever, widal titer, resistance

Haematological responses of nile tilapia (Oreochromis niloticus Linnaeus 1758) to exposure to effluent from palm oil mills (POME)

Pollution by palm oil mill effluent (POME) is of great concern in Indonesia. POME pollution of the water can adversely affect aquatic organisms, especially fish. This study aims to analyse the effect of POME on the haematology of tilapia (Oreochromis niloticus), including red blood cells (RBC), white blood cells (WBC), haemoglobin (Hb), Mean Corpuscular Haemoglobin Concentration (MCHC), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Volume (MCV) and haematocrit. A random experimental design was used (CRD) consisting of four treatments and five replications, including a Control (0% POME): Treatment A (10% of LC50-96 hours: 1.565 mg l−1), Treatment B (15% of LC50-96 hours: 2.347 mg l−1) and Treatment C (20% of LC50-96 hours: 3,130 mg l−1). The analysis of blood of fish exposed to POME for 15, 30 and 45 days revealed significant effects (p &lt; 0.05) only on Hb and MCH on day 15 and WBC on day 30. This study indicates that exposure to POME can reduce the WBC value of tilapia recorded on day 30 in treatment C to a level lower than that recorded in other treatments. The Hb value recorded for tilapia exposed to POME on day 15 in treatment C was significantly higher than in the other treatments. Furthermore, POME caused a significant decrease in MCH recorded on day 15, with the lowest value recorded in treatment A. Based on the results of this study, POME can cause a significant decrease in WBC recorded on day 30 and MCH on day 15 and increase in Hb on day 15 in tilapia.