EFFECTS OF PROBIOTIC SACCHAROMYCES BOULARDII AND CO-TRIMOXAZOLE ON SOME HAEMATOLOGICAL PARAMETERS IN ADULT WISTAR RATS

Saccharomyces boulardii is a probiotic yeast used as a nutritional supplement. Co-trimoxazole, is a broad-spectrum antimicrobial agent used in the prophylaxis and treatment of infections.The goal of this study was to evaluate the individual and interactive effects of probiotic Saccharomyces boulardii and co-trimoxazole on some haematological parameters in albino rats. Thirty (30) albino Wistar rats weighing 150-200g were divided into five groups; Basal, A, B, C, and D, with six animals in each group. Group A (control) was given a normal rat pellet (standardized feed) and clean water (pH 6.5- 8.5). Group B was administered 5.5mg/kg body weight of the commercial probiotics (Saccharomyces boulardii). Group C was administered 4.4mg/kg body weight of co-trimoxazole. Group D was administered 5.5mg/kg body weight of the commercial probiotics and 4.4mg/kg body weight of co-trimoxazole. All administrations were done using a gavage tube for 15 days. Blood samples were collected for analysis on days 0, 5 and 15. The results showed that Saccharomyces boulardii caused a significant increase (P<0.05) in total white blood cell count and packed cell volume of the treated groups at day 5. On day 15, the total white blood cell count (10.67±0.66), packed cell volume (43.23±0.47), platelet count (932±38.89) and mean platelet volume (8.53±0.38) showed a significant increase (P<0.05) in the probiotic group. The co-trimoxazole group showed a significant reduction (P<0.05) in the packed cell volume and total white blood cell count. This study shows that Saccharomyces boulardii has a positive effect on the haematological profile of the test animals.

Use of Haematological Changes as a Predictor of Dengue Infection among Suspected Cases at Kairuki Hospital in Dar Es Salaam, Tanzania: A Retrospective Cross Sectional Study

Background: Dengue is a viral disease transmitted by female Aedes mosquitoes which are commonly found in tropical and subtropical areas. There is a dramatic increase in annual incidence rate of dengue attributed to urbanisation, poor environmental management as well as increased people mobility. Outbreak of dengue have been reported in Tanzania in recent years with Dar es salaam being the most affected region. Dengue is associated with haematological derangements and itindicates the severity of the disease. These changes have not been well elucidated in Tanzanian patients. The aim of this study was to determine these derangements among dengue patients admitted at Kairuki hospital in Dar es salaam, and compare these changes with non- dengue febrile patients. Methods: A retrospective cross sectional study was conducted among patients who were suspected to have dengue; tested for dengue IgM and their Complete Blood Count were tested during the index illness. This information was obtained from Kairuki hospital laboratory database. Haematological parameters were compared between dengue and non-dengue patients using SPSS Version 20.0. Binary logistic regression analysis was used to determine haematological predictors of dengue positive results. Results: A total of 255 patients were enrolled, whereby 188(73.7%) were dengue positive and 67 (26.3%) were negative. Dengue patients had relatively low mean total white blood cell counts compared to non-dengue patients (Student’s test= -2.7; p value=.007). Furthermore, Mean lymphocyte count was significantly low in dengue patients compared to non-dengue patients (Student’s (t) test=-5.1; p<.001). Other haematological parameters were not significantly different. Lymphopenia was a significant predictor for dengue positive results (Adjusted Odd Ration =5.26 (95% CI=2.28-12.2; P value <.001). Conclusion: Patients with dengue had significantly low total white blood cell and lymphocyte count compared to non-dengue febrile patients. Lymphopenia is a significant haematological predictor for dengue positive results. Case defining signs and symptoms combined with these haematological changes may be used by clinicians as a guide to order confirmatory test for suspected dengue cases.

MO020AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE, CYTOPENIA AND POSTTRANSPLANT OUTCOMES: A RETROSPECTIVE ANALYSIS

Background and Aims Autosomal dominant polycystic kidney disease (ADPKD), the most common monogenetic inherited kidney disease, has been reported to be associated with distinct cytopenias. The pathophysiological mechanism behind this association and its clinical implications are unknown. Sparse and conflicting data have suggested a tendency to greater vulnerability for cancer and infections in ADPKD renal transplant recipients as compared to their non-ADPKD counterparts. Furthermore polycystin expression has been demonstrated in lymphocytes in vitro with impact on lymphocyte function. From this background, cytopenia could be hypothesized to be directly induced by the molecular PKD defects and to impact on outcome in affected patients. The main interest of the current study is to confirm the association between ADPKD and cytopenia in a well-defined clinical cohort of patients at the time of kidney transplantation. Furthermore, the impact of ADPKD and cytopenia on posttransplant outcomes is studied. Method Baseline (pre-transplantation) and follow-up data from all patients who underwent a first renal transplantation between 01/04/1964 and 01/09/2019 at the Leuven University Hospitals were retrieved from the renal transplantation database. Results 4103 patients were included: 611 ADPKD and 3492 non-ADPKD. Immediately before transplantation, significant differences in total white blood cell (6.33 +/- 2.59 ADPKD versus 7.17 +/- 2.21 non-ADPKD; p&lt;0.0001), neutrophil (4.04 +/- 1.59 versus 4.54 +/- 1.88; p&lt;0.0001), lymphocyte (1.45 +/- 0.05 versus 1.57 +/- 0.68; p&lt;0.0001), basophil (0.041 +/- 0.084 versus 0.046 +/- 0.048; p&lt;0.0001), eosinophil (0.23 +/- 0.24 versus 0.29 +/- 0.33; p&lt;0.0001) and thrombocyte counts (203.00 +/- 67.21 versus 230.18 +/- 76.00; p&lt;0.0001) between ADPKD and non-ADPKD patients were observed. After multiple linear regression analysis, ADPKD remained significantly associated with total white blood cell, neutrophil, monocyte and thrombocyte counts. In terms of post-transplant outcomes, significant univariate differences between ADPKD and non-ADPKD transplant recipients in favor of the ADPKD patients were observed for overall survival, time to first rejection and time to transplant failure. On the contrary, a significantly faster onset of the first posttransplant malignancy and infection was observed in ADPKD as compared to non-ADPKD. Furthermore, the numbers of posttransplant infections and malignancies tended to be higher in the ADPKD patient cohort, the number of transplant rejections was significantly lower. While pre-transplantation lymphopenia was univariately associated with lower overall survival, none of the other post-transplant outcomes was associated with lymphopenia, nor with any of the other blood cell counts. After multivariate Cox proportional hazard regression analysis, ADPKD remained significantly associated with time to first rejection (p=0.0310; HR 0.632) and overall survival (p&lt;0.0001; HR 0.512). None of the blood cell count variables retained significance in the multivariate outcome models. Conclusion This large retrospective single center study confirmed the association between cytopenia and ADPKD immediately before kidney transplantation. Furthermore, ADPKD was also associated with differences in posttransplant outcomes. In multivariate survival analysis, the impact of ADPKD on outcomes outweighed that of other variables, amongst others the blood cell counts. From this, it is tempting to speculate that ADPKD influences outcome through a disease-related impact on blood cells, however many more factors are most probably involved. The hypothesis that cytopenia could be an extra-renal manifestation of ADPKD, directly linked to its genetic basis, and its impact on outcome warrant further investigation.

Haematological Profile of Naturally Infected Haemoparasite Positive and ‎Negative Japanese Quails (Coturnix coturnix japonica)

Commercial quail farming is economically viable and feasible because quails are resistant tovarious diseases. But despite this reported resistance, little is known about its resistance tohaemoparasites. This study evaluates the haematological changes and haemoparasiticinfection of commercially raised quails. Fifty-seven adult quails raised on deep litter wererandomly selected for blood sampling in this study. Two milliliters of blood was collectedaseptically for complete blood count while blood smears were used for the determination ofhaemoparasite morphological characteristics. Haemoproteus spp. Plasmodium gallinaceum, and Leucocytozoon spp. were identified in this study. 38 (67%) of the quails were positive forsingle or mixed infection, 29 (51%) were positive for single infection and 9(16%) for mixedinfection. There was a (P<0.05) decrease in PCV, Hb, and RBC counts, and an increase inTWBC and eosinophil count in birds with haemoparasite as compared to the uninfected birds.There was (P<0.05) increase in total white blood cell and heterophil count in the plasmodiumpositive birds. Also, total white blood cell, heterophil, lymphocyte and eosinophil count were(P<0.05) increased in the Leucocytozoon positive birds. This increase was also observed inbirds with mixed infection. The high incidence of haemoparasitic infection in apparentlyhealthy quail, with significant haematological indices deviated from normal, is consistentwith reports of the resistance of quail to various disease diseases which thus includeshaemoparasitic infection.

Workup for eosinophilia

With automated differentials being a common part of routine blood counts, the finding of eosinophilia is a relatively frequent occurrence. The first step in elucidating the cause is to determine the absolute eosinophil count (AEC), which is calculated from multiplying the percentage of eosinophils by the total white blood cell count. Eosinophilia is defined as an AEC of >500 eosinophils/μL, whereas hypereosinophilia is defined as an AEC of ≥1500 eosinophils/μL, a separation that is useful as an initial approach to the evaluation of such patients. Peripheral blood eosinophilia is most commonly secondary to allergies but can also be caused by certain infections, medication reactions, autoimmune diseases, or other conditions. However, hypereosinophilia is rarely, if ever, explained by allergy alone and should always prompt a further workup. A meticulous approach to exploring key aspects of the medical history is recommended for assessing increased AECs because it helps to narrow the list of possible etiologies, and treatment varies, depending on the underlying diagnosis. Special attention should be paid to the onset of eosinophilia and any coincident events, such as travel or the start of new medications. Another critical part of the history is a thorough attempt to identify any possible eosinophil-associated end-organ damage, although a biopsy of suspected involved areas is often necessary for confirmation. Because the causes of an elevated AEC are broad, determining the trigger or underlying disorder becomes an important intellectual riddle that can usually be solved with careful attention to history, physical examination, and appropriate laboratory work.