Bilateral Optic Neuritis Caused by Meningococcal Meningoencephalitis

In this article, we described a case of pathogen-induced bilateral optic neuritis accompanying meningococcal meningoencephalitis in an adolescent male. A 15-year-old boy presented to our emergency room due to progressive severe headache, stiff neck, diffuse extremity pain, fever, and nausea concerning meningoencephalitis. Intravenous ceftriaxone, metamizole, and ondansetron were started immediately. Due to acute autonomic dysregulation and development of petechiae, he was transferred to the pediatric intensive care unit. Next morning, the patient developed severe visual impairment. Investigations revealed elevated C-reactive protein, procalcitonin and leucocyte count, decreased platelet count, and clotting activation. Cerebrospinal fluid (CSF) analysis revealed increased leucocyte count, protein, and decreased glucose concentration with pathological CSF cytology. Brain magnetic resonance imaging revealed an increased contrast enhancement in the optic nerve sheath, consistent with acute bilateral optic neuritis. He was started on high-dose intravenous pulse methylprednisolone therapy. After treatment with ceftriaxone und pulse steroids, the patient was discharged in good condition without any visual sequel.

Acute and Chronic Effects of Interval Training on the Immune System: A Systematic Review with Meta-Analysis

Purpose: To summarize the evidence regarding the acute and chronic effects of interval training (IT) in the immune system through a systematic review with meta-analysis. Design: Systematic review with meta-analysis. Data source: English, Portuguese and Spanish languages search of the electronic databases Pubmed/Medline, Scopus, and SciELO. Eligibility criteria: Studies such as clinical trials, randomized cross-over trials and randomized clinical trials, investigating the acute and chronic effects of IT on the immune outcomes in humans. Results: Of the 175 studies retrieved, 35 were included in the qualitative analysis and 18 in a meta-analysis. Within-group analysis detected significant acute decrease after IT on immunoglobulin A (IgA) secretory rate (n = 115; MD = −15.46 µg·min−1; 95%CI, −28.3 to 2.66; p = 0.02), total leucocyte count increase (n = 137; MD = 2.58 × 103 µL−1; 95%CI, 1.79 to 3.38; p < 0.001), increase in lymphocyte count immediately after exercise (n = 125; MD = 1.3 × 103 µL−1; 95%CI, 0.86 to 1.75; p < 0.001), and decrease during recovery (30 to 180 min post-exercise) (n = 125; MD = −0.36 × 103 µL−1;−0.57 to −0.15; p < 0.001). No effect was detected on absolute IgA (n = 127; MD = 47.5 µg·mL−1; 95%CI, −10.6 to 105.6; p = 0.11). Overall, IT might acutely reduce leucocyte function. Regarding chronic effects IT improved immune function without change leucocyte count. Conclusion: IT might provide a transient disturbance on the immune system, followed by reduced immune function. However, regular IT performance induces favorable adaptations on immune function.

A Cross Sectional Study to Assess the Status of Hemoglobin and Other Blood Indices among Pregnant Women Attending Tertiary Care Hospital of Vadodara

Introduction: A number of adaptations happen in the anatomy, physiology and metabolic processes within the mother which aids in successful progression of the pregnancy. The different blood indices such as haemoglobin concentration, packed cell volume (PCV), red blood cell count; total WBC count etc. can be measured to evaluate haematological status in a pregnant woman. The hematological profile of the pregnant women has an impact on both pregnancy and its outcome. Anaemia in pregnancy can be leads to morbidity and mortality in mother and fetus. The current study was designed to determine the variation in status of hemoglobin and other blood indices in anemic and non-anemic pregnant women. Aims ans Objectives: 1. To study the hematological and other blood indices among pregnant women, 2. To assess the degree of anemia in pregnant women, 3. To compare the Various hematological parameters between anemic and non -anemic pregnant women. Materials and Methods: A Cross-sectional comparative descriptive survey design and quantitative approach was adopted to achieve the goal of the study. The study was conducted at the tertiary care hospital of Vadodara, Gujarat. Total 300 pregnant women were recruited and socio demographic information was collected. Hemoglobin concentration (Hb), total leucocyte count (TLC), differential leucocyte count (DLC), and platelet count, blood indices of the recruited samples were studied.Mean and SD of Haematological parameters were calculated and unpaired t-test was used to compare the pregnant anaemic women data with non-anaemic pregnant women. Results: Out of 300, 204 pregnant women were found anemic and most of the pregnant women 84% belonged to rural area. In accordance with severity of anemia, Moderate degree of anemia was found to be highest (41%) in anemic pregnant women. Comparison of non - anaemic pregnant women with anaemic pregnant women shows significant changes in haematological parameters (p <0.05). Conclusion: It can be concluded that there is significant changes in hematological parameters in each trimesters of pregnancy as well compare to non-anemic to anemic pregnant women. Most of the hematological changes occur in order to physiological adaptation of pregnancy but abnormal status of Haemoglobin and other blood indices cause adverse outcome of the pregnancy.

A Case of a Rapidly Growing Granulocyte Colony-Stimulating Factor-Producing Squamous Cell Carcinoma of the Breast

A 34-year-old woman with a rapidly growing right breast mass visited our hospital. The mass was diagnosed as a right breast cancer (cT3N1M0 stage ⦀A). Her serum leucocyte count and C-reactive protein levels were high, and she had persistent fever. However, serum procalcitonin and β-D-glucan levels were normal, and no apparent infection focus was detected, although her serum granulocyte colony-stimulating factor (G-CSF) level was markedly elevated to 42.7 pg/mL. Therefore, a G-CSF-producing breast cancer was suspected. A pathological analysis of the surgical specimen revealed a squamous cell carcinoma of the breast (pT2N0 [i+] M0 stage ∥A). Right mastectomy (with the resection of the pectoralis major muscle), axillary lymph node dissection, and split layer grafting were performed. The leucocyte count and serum G-CSF level decreased on postoperative day (POD) 1 and normalized on POD 6. As adjuvant chemotherapy, 4 cycles of a combination chemotherapy with adriamycin and cyclophosphamide and 12 cycles of weekly paclitaxel were administered. After chemotherapy, the patient also underwent postmastectomy radiotherapy. Currently, 30 months after surgery, the patient is alive and well with neither progression nor distant metastasis. G-CSF-producing breast cancers tend to rapidly grow such as in the current case; thus, surgery should be performed immediately, followed by appropriate adjuvant treatment.

EFFECT OF CURCUMIN ON SIDE EFFECTS OF CHEMOTHERAPY AS ASSESSED BY COMPLETE BLOOD COUNTS, R.F.T., L.F.T. IN PATIENT OF HAEMATOLOGICAL MALIGNANCIES AND SOLID TUMOURS

Background: Effect of curcumin on side effects of chemotherapy as assessed by complete blood counts, R.F.T., L.F.T. in patient of haematological malignancies and solid tumours. Methods: The study population consisted of male and female patients of Haematological Malignancies & patient of solid tumours (stage 3 & 4 lung, breast, head & neck, ovary Cancer) selected from patients attending medical, radiotherapy and Birla Cancer OPD and medical in-patient wards. Results: Comparing of total leucocyte count, absolute neutrophil count and platelet count of group A1 and B1 at 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks, there is no significant difference found. Comparing of total leucocyte count and platelet count of group A2 and B2 at 4, 8, 12, 16, 20 and 24weeks, there is no significant difference found. Conclusion: No dose-limiting toxicities were seen in group-A for curcumin. Derangement of liver function tests occurred in 1 (5%) patients from group-A1 and 2 (10 %) patients from group-B1. No renal toxicity was encountered in group-A1 and B1. Keywords: Neutrophil, Leucocyte, Haemoglobin

Correlation between haematological profile and body mass index in adults

Obesity is defined as excessive accumulation of fat in various tissues in the body which causes ill health in the body. The basic cause of obesity is imbalance between calories intake and calories expenditure There is increased intake of calorie rich foods and reduced physical activity due to urbanization all over the world.Body mass index is simple formula to classify obesity in adults. It is defined as person’s weight in kilograms divided by height in meter squares (m).Obesity and elevated BMI are the major causes for development of chronic diseases like stroke, hypertension, Type 2 diabetes and other cardiovascular disorders.BMI is the modifiable risk factors of type 2 diabetes, hypertension, stroke and cardiovascular diseases. This study was undertaken to assess the relationship between BMI and haematological profile among young Indian population. This study comprises 200 participants comprising 100 males and 100 females aged between 18 to 30 years. The design for this study was cross-sectional survey. Ethical approval was taken from ethical committee of BMCH, Chitradurga. Under aseptic precaution, 10 ml of venous blood sample collected from antecubital vein and then transfererd to EDTA tube. Then haematological parameters like PCV, Haemoglobin concetration, RBC, WBC count was estimated using sysmex haematology anlyser.Subjects were grouped into underweight, normal, overweight and obese subjects. Stastical significance was determined by ANOVA. Scheffe post-hoc test was used to determine significance while pearson correlation was used to determine relationship between the variables. Data was analysed using SPSS software and presented as mean± standard deviation. Values of P ≤ 0.05 were considered significant.In our study, PCV is statistically increased in overweight and obese individuals as compared to other BMI groups in both males and females. Total leucocyte count was significantly higher in overweight and obese subjects when compared to normal subjects. We found no change in Haemoglobin concentration and RBC count in all BMI groups.In our study we observed, leucocytosis and higher PCV in overweight and obese individual groups when compared to underweight and normal weight BMI groups. There is direct positive correlation between BMI and total leucocyte count. RBC count and haemoglobin concentration shows no statistical significance among all BMI groups.There is need for promotion of a healthy life style, regular exercise, healthy nutrition, stress free life in young population.

Occurrence of Adrenal Suppression in Patients Having Sepsis in Indian Population and Impact of Corticosteroid Supplementation on Its Overall Survival

Objective Our aim was to estimate the occurrence of adrenal suppression in critically ill patients with septic shock who have got admission in intensive care unit and to evaluate the effectiveness of hydrocortisone in these patients in relation to mortality of patient, development of septic shock, and effect on total leucocyte count. Methods Serum cortisol was measured in 120 patients with sepsis. Patients with decreased cortisol level were split in to two groups (group A and B). Group A received 50 mg of hydrocortisone 6 hourly and group B was given matching placebo. At day 7, serum cortisol level was estimated for both A and B groups. The results were calculated and compared with relation to incidence of adrenal insufficiency, development of septic shock, effect on total leucocyte count, and survival at 28 days. Results The occurrence of adrenal suppression in patients having sepsis in our study was 44 out of 120 patients, that is, 36.6%. After supplementation of corticosteroid for 7 days the mean value of serum cortisol of group A was 40.38 ± 8.44 µg/dL and group B was 24.30 ± 6.47 µg/dL (p < 0.001). At day 7, in group A, 22.7% developed septic shock, whereas in group B, 36.4% developed septic shock (p < 0.001). In group A and B, mortality rate of the patients at 28 days was 18.2 and 22.7%, respectively. Conclusion Hydrocortisone supplementation in critically ill patients with low random basal serum cortisol level with sepsis does not significantly improve the overall survival.

The haemato-metabolic profile of high producing dairy cows during the transition period

The objective of the present study was to assess the haematological [haemoglobin, packed cell volume (PCV), total erythrocyte count (TEC), erythrocytic indices, total leucocyte count (TLC) and differential leucocyte count (DLC)] changes and metabolic adjustment, viz. blood glucose, blood urea nitrogen (BUN), non-esterified fatty acid (NEFA) and cholesterol, in high-yielding Sahiwal and Karan Fries cows during the transition period. For this purpose, blood samples were collected from 8 pregnant Karan Fries crossbred cows and 8 pregnant Sahiwal cows on days -15, -7, 0 (the day of calving), +7 and +15 from calving, and used for estimation of haemoglobin, PCV, TLC, TEC, erythrocytic indices and DLC, and metabolic parameters, such as blood glucose, BUN, NEFA and cholesterol. It was found that haemoglobin concentrations, PCV and TEC increased significantly (P<0.01) up to the day of calving, and gradually decreased thereafter to reach pre-partum levels in the subsequent weeks post-calving. While the TLC, number of neutrophils and monocytes were found to increase (P<0.01), the number of lymphocytes decreased significantly (P<0.01) on the day of calving and then reached pre-partum levels after calving. No significant effect was observed on erythrocytic indices parameters. Blood glucose, BUN and NEFA levels showed an increasing trend (P<0.01) from 2 weeks pre-partum until the day of calving, and then decreased to the pre-partum level after calving. Unlike the other parameters, the plasma cholesterol level increased consistently from 2 weeks pre-partum to 2 weeks post-partum. In conclusion, the results of our study clearly show a definite pattern of the haematological and metabolic adjustment of high-producing dairy cows during the pre-partum to postpartum transition.

Microbial aspects and potential markers for differentiation between bacterial and viral meningitis among adult patients

Objectives Meningitis is a medical emergency with permanent disabilities and high mortality worldwide. We aimed to determine causative microorganisms and potential markers for differentiation between bacterial and viral meningitis. Methodology Adult patients with acute meningitis were subjected to lumber puncture. Cerebrospinal fluid (CSF) microorganisms were identified using Real-time PCR. PCT and CRP levels, peripheral and CSF-leucocyte count, CSF-protein and CSF-glucose levels were assessed. Results Out of 80 patients, infectious meningitis was confirmed in 75 cases; 38 cases were bacterial meningitis, 34 cases were viral meningitis and three cases were mixed infection. Higher PCT, peripheral and CSF-leukocytosis, higher CSF-protein and lower CSF-glucose levels were more significant in bacterial than viral meningitis patients. Neisseria meningitides was the most frequent bacteria and varicella-zoster virus was the most common virus. Using ROC analyses, serum PCT and CSF-parameters can discriminate bacterial from viral meningitis. Combined ROC analyses of PCT and CSF-protein significantly improved the effectiveness in predicting bacterial meningitis (AUC of 0.998, 100%sensitivity and 97.1%specificity) than each parameter alone (AUC of 0.951 for PCT and 0.996 for CSF-protein). Conclusion CSF-protein and serum PCT are considered as potential markers for differentiating bacterial from viral meningitis and their combination improved their predictive accuracy to bacterial meningitis.