Correlation of Nutritional Status with Haematological Profile in Undergraduate Medical Students

Background and Aim: Anaemia is a major global health problem affecting all sections of the population. Adolescents are vulnerable to malnutrition and anaemia. Considering the ever rising burden of anaemia in our country, the present study was carried out to detect prevalence of anaemia in undergraduate medical students and to evaluate correlation between nutritional status and anaemia. Correlation between gender and anaemia was also analysed. Methods: Study was carried out in 60 students of I MBBS. Complete blood count was processed on automated haematology analyser. A peripheral blood smear was studied for cell morphology. Dietary history was taken by providing questionnaire and Body mass index (BMI) was calculated using standard protocol. Results were analysed using SPSS. Results: Anaemia was detected in 23.33% students with higher prevalence in female students (44%). Anaemia and its severity were significantly associated with gender. Overall 43.33% students were found to be malnourished. 19.23% of malnourished students were anaemic. 26.47% students with normal BMI were also found to be anaemic. There was no significant association of BMI with anaemia. Variations in values of red cell indices were detected in 08 non-anaemic students, leukocytosis with monocytosis in 01 non-anaemic student and thrombocytosis in 03 anaemic female students. Conclusion: Medical students should be regularly screened for anaemia. Dietary history should be combined with BMI for complete nutritional assessment. Education of students regarding consumption of balanced diet is necessary to prevent nutritional anaemia. Red cell indices should be used to detect anaemia even before fall in haemoglobin levels. Keywords: Anaemia, Body mass index, Haemoglobin, Red cell indices, RDW, Diet.

Hematological changes in hypothyroidism and hyperthyroidism in adults

Thyroid function disorders are among the most common endocrine diseases. Thyroid disorders can cause certain forms of anemia, more commonly in hypothyroidism. Slightly decreased TLC, relative neutropenia, relative lymphocytosis or relative eosinophilia may be found in thyroid disorders. These observations confirmed the association between thyroid gland dysfunction and hemopoiesis.1) To study the pattern of hematological changes in thyroid dysfunction 2) To correlate thyroid function tests with complete blood count & red cell indices findings 3) To correlate complete blood count investigations and peripheral blood smear findings with serum TSH levels.It was an Observational study conducted during 18 months of period from March 2018 to October 2019 with 100 subjects of hypothyroidism, 80 subjects of hyperthyroidism and 100 euthyroid subjects as control group. CBC was done on automated cell counter. PBS was stained with Leishman stain and observed under microscope. TFTwas done by immunoassay method. It was done with SPSS Software.: Predominance of female was seen in hypothyroidism and hyperthyroidism. Significant decrease was seen in RBC, Hb, HCT, MCV and MCH in hypothyroid group, while in hyperthyroid group RBC, Hb and HCT were significantly decreased as compared with euthyroid control group. Both groups showed significant increase in RDW as compared with control group.It is important to carefully evaluate the thyroid hormones in cases of unexplained anemias. So, periodic evaluation for probable hematological changes should be done in all the patients with hypothyroidism and hyperthyroidism.

An Early Diagnosis of Thalassemia: A Boon to a Healthy Society

The β-thalassemia is a hereditary blood disorders, characterized by reduced or absent synthesis of the hemoglobin beta chain that cause microcytic hypochromic anemia. An early diagnosis, economical test, awareness programs and prenatal screening will be a milestone for the eradication of this genetic disorder and to reduce burden of the health sector of a country subsequently the economics. Initially, the diagnosis of β-thalassemia depends on the hematological tests with red cell indices that disclosed the microcytic hypochromic anemia.Hemoglobin analysis shows the abnormal peripheral blood smear with nucleated red blood cells, and reduced amounts of hemoglobin A (HbA). In severe anemia, the hemoglobin analysis by HPLC reveals decreased quantities of HbA and increased the level of hemoglobin F (HbF).The decrease level of MCV and MCH are also associated with β-thalassemia. There are various different molecular techniques such as ARMS PCR, allele-specific PCR, Gap PCR, denaturing gradient gel electrophoresis, reverse dot blotting, DGGE, SSCP, HRM, MLPA, sequencing technology and microarray available to identify the globin chain gene mutations. These molecular techniques can be clustered for detection by mutation types and alteration in gene sequences.

Consumption of Sinlek Rice Drink Improved Red Cell Indices in Anemic Elderly Subjects

Iron fortifications are used for the treatment of iron-deficiency anemia; however, iron dosing may cause oxidative damage to the gut lumen. Thai Sinlek rice is abundant in iron and contains phytochemicals. We aimed at evaluating the effect of an iron-rice (IR) hydrolysate drink (100 mL/serving) on neurological function, red cell indices and iron status in elders. Healthy elderly subjects were divided into three non-anemic groups and one anemic group. The non-anemic groups consumed one WR (2 mg iron/serving) and two IR drinks (15 and 27 mg iron/serving) (groups A, B and D, respectively), while the anemic group consumed one IR drink (15 mg iron serving) (group C) every day for 30 days. There were no significant differences in the MMSE Thai 2002 and PHQ9 test scores for members of all groups, while the nutrition scores and body weight values of group D subjects were significantly increased. Hemoglobin (Hb) and mean corpuscular hemoglobin concentrations increased significantly only in group C. Serum iron and transferrin saturation levels tended to increase in group A, while these levels were decreased in members of group C. Serum antioxidant activity levels were increased in all groups, and were highest in group C. Thus, consumption of an IR drink for 15 days functioned to increase Hb and antioxidant capacity levels in anemic elders.

TP7.2.11 Hypochromia is an early marker of iron deficiency anaemia

Aim Microcytosis in iron deficiency anaemia triggers an urgent referral for investigation of suspected gastrointestinal cancers. This study evaluated whether the inclusion of hypochromia as a marker for iron deficiency would lead to earlier referrals. Method Consecutive patients referred from primary care under the 2-week wait suspected gastrointestinal cancer pathway with unexplained iron deficiency anaemia between October 2019 and October 2020 were included. Results of red cell indices were obtained from an electronic platform for accessing laboratory test results(Sunquest ICE™, Version 5.4, Sunquest Information Systems). Mean corpuscular haemoglobin (MCH) of 27-32pg and mean corpuscular volume (MCV) of 80-102fL were considered normal. Results Seventy nine patients (32 men, 47 women) were included. Median (IQR) age was 73 (62-80) years. 67% (53/79) had a low MCH and 43% (34/79) had a low MCV at the time of referral. In the preceding months of referral (median [IQR] 4.3 [1.8-7.9] months) 64 patients had a full blood count performed of which 55% (35/64) had a low MCH and 20% (13/64) had a low MCV. The earliest available full blood count prior to referral (43 patients, median (IQR) of 16.5 (12-37) months) showed that 86% (37/43) had a low MCH compared to 33% (14/43) with a low MCV. A fall in MCH always preceded a fall in MCV at all the three time points analysed. Conclusion The inclusion of hypochromia as a marker of iron deficiency in the referral criteria for suspected gastrointestinal cancers would trigger significantly earlier referrals.

Correlation of HbF, HbA2, and HbS in sickle cell disease and its prevalence in Nigerian patients: A case series of 2 patients

Sickle cell disease (SCD) is the most common inherited disorder of hemoglobin worldwide. In Nigeria, the prevalence of SCD is 20–30/1000 live births. The burden of the disease has reached a level where it contributes 9–16% of the under-five mortality in many West African countries. This case series evaluated the chromatographic patterns and red blood cell indices of sickle cell homozygous patients. Red cell indices, blood film, sickle solubility test, and chromatographic patterns using Bio-Rad HPLC D10 were evaluated for both patients. Both the patients were Nigerian and HPLC showed HbS window 81.7 and 81.6% and increased HbF, that is, 7.5 and 8.8%. HbA2 was normal in both the cases, that is, 2.2 and 2.6%. Our data suggest that homozygous sickle cell disease is very common among the Nigerian population with an increase in HbF along with HbS and HbA2 is normal.

Haematological and Haemostatic Changes Associated with Major Depressive Disorder among Nigerians.

Background: A link between major depressive disorder (MDD) and haematological as well as co-agulation disorders has been postulated. This study aims to evaluate haematological and haemostatic changes among Nigerians with major depressive disorder Methods: Two hundred volunteers consisting of an equal number of individuals diagnosed with major depressive disorder (MDD) based on DMS-IV criteria and apparently healthy control participated in this study. The blood sample was collected into tri-sodium citrate K2EDTA bottles respectively and was evaluated for some haemostatic parameters , using ELISA, Clauss, Quick’s One Stage, Proctor and Rapaport’s methods. Results: The mean WBC, hemoglobin and differential lymphocyte were significantly higher among MDD total volunteers (p < 0.001). The red cell indices and platelet count were lower among MDD (p <0.001). Also the prothrombin time (PT), fibrinogen, protein-C and erythrocytes sedimentation rate (ESR) were all raised (p <0.001) among volunteers with MDD. Positive associations existed be-tween MCV and RBC (r: 0.364; p<0.001), PT and APTT (r: 0.319 p <0.001), APTT and fibrinogen (r: 0.239, p = 0.017) as well as PT and fibrinogen (r: 0.275 p = 0.006) at 95% confidence interval. Conclusion: Changes in total leucocytes count, lymphocytes values and haemostatic parameters among volunteers with depression may impacts deleterious effects on the immune response as well as haemostatic homeostasis, while decreased red cell indices may suggest occult nutritional anaemia.