Haematological Profile in Microcytic Hypochromic Anaemia in Children

INTRODUCTION: The most common disorders presenting with microcytic hypochromic anaemia are iron deficiency anaemia (IDA) and β-Thalassemia trait (β-TT), and each of them has different pathogenesis and treatment modality. Here we intend to see the haematological profile in microcytic hypochromic anaemia in children apart from IDA and Thalassemia with respect to age and gender. MATERIAL AND METHODS: A total of 95 pediatric patients between the ages of 2 to 12 years with microcytic hypochromic anaemia were included in the study. Blood samples obtained from each patient were evaluated for various haematological and biochemical profiles along with haemoglobin electrophoresis. It was a hospital based observational cross-sectional study done for a period of 18 months from January 2019 to July 2020. RESULTS: Severe anaemia was seen in 55 (57.89%) cases, followed by 38 (40.00%) cases with moderate anaemia and 2 (2.11%) cases with mild anaemia. Majority of the cases showed IDA, which were 85 (89.5%) cases, followed by 6 (6.3%) cases with β-TT and 4 (4.2%) cases with β-TM. RBC count, hematocrit and RDW showed significant variation between IDA, β-TM and β-TT. Most number of correctly diagnosed cases were shown by Ricerca Index with 90 (94.74 %). CONCLUSION: Our study concludes RBC count and RDW, along with Srivasthava Index, Ricerca Index and RDW Index could be used as reliable indices to differentiate between iron deficiency anaemia and β-Thalassemia. Red cell indices, serum iron profile and haemoglobin electrophoresis complement each other for the precise diagnosis of underlying cause of microcytic hypochromic anaemia.

Evaluation of Variations in the Various Blood Indices in COVID-19 Recovered Patients

Introduction: In December 2019, cases of pneumonia with an unknown cause were reported in Wuhan, Hubei Province, China. Novel coronavirus infectious disease (COVID-19) has been spreading worldwide and tracking laboratory indexes during the diagnosis and treatment of patients with severe COVID-19 can provide a reference for patients in other countries and regions. The disease is caused by the Severe Acute Respiratory Syndrome Coronavirus according to studies, and the World Health Organization just dubbed it coronavirus disease 2019. Aim: The aim of this analysis was to evaluate COVID-19 patients' blood parameters changes in comparison with healthy controlled patients. Methods: Blood samples were taken from 10 patients in which 5 are COVID-19 recovered patients and 5 are healthy controls. For these blood samples TBC (Total Blood Count) was taken and the readings of RBC, hemoglobin, WBC, lymphocyte, granulocyte and platelets count was recorded. Independent t-test was done to obtain the results. SPSS software Version 23 was used to give the output comparison as error bar charts. Results: The patients have increased RBC count, increased hemoglobin and reduced WBC count with reduced lymphocytes and Granulocytes counts. Here it can be concluded that COVID-19 recovered patients should take care of themselves by having proper care, doctor consultation and follow up. Conclusion: From this study it can be understood that COVID-19 recovered patients have increased RBC count and hemoglobin percentage. The recovered patients have reduced WBC, lymphocytes and Granulocytes percentage.

Case Report on Sickle Cell Anaemia (SS Pattern)

Sickle cell anemia is a kind of hemolytic anemia that is passed down in families. It is a kind of hemolytic anemia caused by inheriting the sickle hemoglobin gene. Africans, as well as individuals from the Middle East, the Mediterranean region, and India's aboriginal tribes, have a lower level of the sickle hemoglobin (HbS) gene. A kind of anemia that affects both children and adults is sickle cell anemia. Clinical Finding: Since 5 days, A 25-year-old man has been experiencing generalized bodily pain and anxiety. Examining the Problem: ALT (SGPT)- 97 U/L, AST (SGOT)- 56 U/L, total bilirubin – 5.4 mg percent, bilirubin conjugated – 1.7 mg percent, bilirubin unconjugated – 3.7 mg percent, total RBC count – 3.71 million/cu mm, total WBC count – 22100 cu mm, total platelets count – 6.46 lack/cu. Ultrasonography: Heterogeneous spleen. Therapeutic Intervention: Inj. Piptaz 4.5 gm TDS, inj. Levoflox 500 mg, tab. Hydroxyurea 500 mg, tab. Neurobion forte, inj. Pan 40 mg, inj. Tramadol 100 mg. Outcome: The client's condition has improved as a result of the treatment. He has no longer generalized bodily aches, and his anxiety levels have decreased. Conclusion: A 25-year-old man was admitted to Acharya Vinoba Bhave Hospital's Medicine ward with a history of sickle cell anaemia and complaints of nonspecific body aches and anxiousness. His condition improved after he received proper therapy.

Sublethal Effects of Arsenic on Oxygen Consumption, Hematological and Gill Histopathological Indices in Chanos chanos

Background: The current study was performed aiming to evaluate possible changes in the effect on oxygen consumption, hematology and gill histopathological parameters in fish (Chanos chanos) upon exposure to sublethal concentration of the metalloid arsenic. Methods: Bioassay tests were conducted for determining the LC50 values of arsenic for 96 h. Oxygen consumption in control and arsenic-exposed fish was estimated using Winkler’s method. Red blood corpuscular (RBC) count was examined with a Neubauer counting chamber under a phase contrast microscope. Hemoglobin (Hb) was estimated following the acid hematin method. Histopathological studies were carried by processing and staining the gill tissues with hematoxylin and eosin in accordance with standard histological techniques. They were then subjected to examination under a scanning electron microscope. Results: Chanos chanos exposed to 1/10th of LC50 (24.61%) for a period of 30 days exhibited a maximum decline in the rate of respiration, followed by a decline in RBC and Hb above 45.59% and 51.60%, respectively. Significant toxic lesions encompassing fused gill lamellae, detached gill epithelium, hyperplasia and hypertrophy of respiratory epithelium became heavy handed on the 30th day. Conclusion: Information synthesized from our study serves to be useful in monitoring and managing (As) contamination in the aquatic environment.

Red Blood Cell Count: An Unrecognized Risk Factor for Nonalcoholic Fatty Liver Disease

ObjectiveNonalcoholic fatty liver disease (NAFLD) is becoming a global public health challenge. A convenient NAFLD indicator will greatly facilitate risk appraisal and prevention. As a readily available and inexpensive hematological index in routine clinical examinations, red blood cells (RBCs) are gaining increasing attention in many diseases, such as metabolic syndrome, but their association with NAFLD is unknown.MethodsThis health management cohort study included 27,112 subjects (17,383 non-NAFLD and 9,729 NAFLD) with up to 5 years of follow-up (median 2.8 years). NAFLD was diagnosed by ultrasonography. NAFLD severity was categorized as mild, moderate, or severe. The generalized estimation equation (GEE), an extension of generalized linear models that allows for analysis of repeated measurements, was used to analyze the association between RBC count and NAFLD.ResultsOverall, 4,332 of 17,383 (24.9%) subjects without NAFLD at baseline developed NAFLD. Incident NAFLD risk was positively associated with RBC count. After adjustment for hemoglobin and other confounders, the risk of incident NAFLD was 21%, 32%, and 51% higher in the second, third, and fourth RBC count quartiles, respectively, than in the lowest quartile. In 1,798 of 9,476 (19.0%) subjects with NAFLD at baseline, the severity of NAFLD increased. NAFLD progression risk increased progressively as RBC count increased (P for trend < 0.001). Every one-unit (1012 cells/L) increase in RBC count was associated with a 53% [OR 1.53 (95% CI 1.32-1.77)] increased risk for NAFLD progression.ConclusionsElevated RBC count was independently associated with a high risk of NAFLD incidence and progression. This finding revealed a convenient NAFLD risk indicator.

Prevalence and Management of Anemia in Adolescents in Primary Care Settings

Anemia is defined as a drop in haemoglobin (Hb), hematocrit (HCT), or red blood cell (RBC) count. Anemia is a widespread issue in primary care, and primary care physicians are generally the first to notice its symptoms. Anaemia is a prevalent clinical concern among the adolescents. It is widely known that haemoglobin levels drop with age increase. Anemia has been linked to a variety of negative effects, including higher mortality, hospitalisation, and a worse quality of life. epidemiological reporting of anaemia is fragmented. Anemia is diagnosed in part by symptoms reported in general practice/family medicine (GP/FM). Management of anemia relies on the type of anemia and underlying cause, in this review we will be looking at Prevalence, etiology, classification and management of Anemia.

Clinico-pathological changes in COVID-19 patients

Background: Novel Corona virus is associated with the respiratory disorder. Corona virus cases disease ranging from a common cold like illness severe acute respiratory syndrome. Biochemical parameters become altered in the patients, and this has been correlated with the severity of the disease. The present study was undertaken to analyse the effect of novel corona virus infection in organs other than lungs.Methods: The study is a retrospective studycarried out in RMCH and RC, Kanpur from July 2020 to June 2021. Haematological, biochemical and inflammatory biomarker study was conducted in 336 COVID-19 patients.Results: Out of 336 COVID-19 patients the maximum number of patients belonged to the age group of 61-70 years. There were 75% symptomatic and 25% asymptomatic cases of confirmed COVID-19. Sore throat was the most common presentation followed by cough and dyspnoea. Other manifestations include fever, myalgia, loss of taste, loss of smell and running nose. Serum CRP and PCT concentration were observed in more severe cases 22.2% and 17% respectively. Haematological findings include decrease in total RBC count (58.33%). Symptomatic COVID-19 patients have thrombocytopenia (30.95%), lymphopenia (25%), leucocytosis (11.90%) and leucopenia 8.33%. Hepatic dysfunction and renal dysfunction was observed in 71.42% and 14.28% symptomatic cases respectively.Conclusions: We concluded that novel corona virus is not only affecting respiratory system but also other vital organs. On the basis of haematological and biochemical findings we can predict the severity of COVID-19 infection which could be helpful for management of the disease.

A SCIENTIFIC DRUG REVIEW ON PUNARNAVA MANDUR

Punarnava Mandura a classical Herbo mineral formulation is available on the market either in tablet form or in Churna form and is frequently used for Anemia, Low Platelet count, Low RBC count, swelling around Joints, Generalized Swelling, Gout and other end toxins accumulation. It is also a diuretic and is useful in renal disorders. In renal failure, it is used with Mutrakrichantak Churna for getting good results. Used with it. This medicine is more commonly used in North Indian Ayurvedic practice. Clinical research involves investigating proposed med- ical treatments, assessing the relative benefits of competing therapies, and establishing optimal treatment combi- nations. It is the most fruitful line of approach for methods of diagnosis and treatment as described in Ayurvedic literature. Anaemia is the most common indicator used to screen for iron deficiency, the terms anaemia, iron defi- ciency, Pandu roga is known since Vedic period and Iron preparations for the treatment of Pandu Roga has also been well known since ancient times. Punarnava as name designates regeneration; it may help to decrease, the work of Kidneys as it has Mutral properties. Keywords: Punarnava Mandur, herbomineral, Anemia.

Case Report on Acute Lymphoblastic Leukemia B-Cell

Introduction: B- Cell lymphoblastic leukaemia of blood cancer that influences B- Lymphocytes, which are white blood cells that create within the delicate marrow of your bones (marrow) [1]. When healthy blood cells start to alter and expand out of control, this is called leukaemia. ALL is a tumour of immature lymphocytes. Lymphocytes are white blood cells that help the immune system function. Acute lymphoid leukaemia (ALL) is also known as acute lymphoblastic leukaemia. ALL is most visits in youthful children and people over the age of 50, but it can influence anybody at any age [2]. Aim: To acquire the knowledge regarding a case of B-cell acute lymphoblastic leukaemia. Clinical findings: Abdominal discomfort, fever high grade, chills, Weakness. Diagnostic Evaluation: Blood Test: Hb-5.5%, Total RBC count-2.21million/cu.mm, Total WBC count- 27400/cumm, RDW- 14.8%, HCT-17.7%, Monocytes-02%, Granulocytes-28%, Lymphocytes-68%, AST(SGOT)-110U/L. Peripheral Smear: RBC: Total RBC Count- Decreased on smear, Haemoglobin- Decreased Predominantly normocytic with few micro showing moderate lymphomia, Platelets- Decreased on smear No hemoparacites are seen, Peripheral smear is suspicious of severe viral infection. Ultrasonography: Splenomegaly. Bone marrow aspiration and biopsy. B-cell lymphoblasts (immature white blood cells) are found in the bone marrow Therapeutic intervention: Blood Transfusion-30 times, Inj Levofloxacin, Inj. Piptaz, Inj. Pan, Inj. Emset, Inj. Doxy, Inj. Hydrocort, Inj. Avil, Tab prednisolone, Tab Dolo. Outcome: After Treatment, The patient shows improvement. His fever and abdominal discomfort were relived and his Hb% increased from 5.5% to 6% after blood transfusion. Conclusion: B-cell acute lymphoblastic leukemia is one of the most common types of leukemia in children but is rare in adults. My patient was admitted to medicine ward no-30, AVBRH with diagnosed of Acute Lymphatic Leukaemia and he had complaint of fever and abdominal discomfort. After getting appropriate treatment his condition was improved.

Heme Scavenging with Apohemoglobin-Haptoglobin Complex in Beta Thalassemia Intermedia Improves Anemia and Iron Indices: A Novel Therapeutic Approach

Beta-thalassemia intermediate (TI) is a genetic disorder of hemoglobin (Hb) synthesis characterized by anemia, ineffective erythropoiesis and iron overload. TI treatment is complex and regular transfusion therapy may be needed for growth failure, skeletal deformity, exercise intolerance, or when Hb levels decline because of progressive splenomegaly. Iron overload can be seen in TI, and serum ferritin measurement may often underestimate the extent of iron overload. There are limited therapeutic options for management of anemia and iron overload in TI. In this study, we look at the potential use of an engineered scavenger protein complex (apoHb-Hp) as a strategy to treat anemia in TI using a C57BL/6 mouse model. Sixteen beta-thalassemic mice (C57BL/6 heterozygous for the Hbb β-globin gene deletion (Hbb td3th/BrjK) (beta-thalassemia, Jackson Laboratory)) were treated with 50 µL of apoHb-Hp complex at a concentration of 27.95 mg/mL for six weeks to simultaneously scavenge cell-free Hb and free heme. Animal weight and RBC parameters (Hb, hematocrit (Hct), red blood cell (RBC) count, red cell distribution width) were measured at baseline and at 6 weeks post treatment. Total iron levels, transferrin concentration and transferrin saturation were measured at the third and sixth week of treatment. At the end of the experiment, the spleen and liver weights were measured and markers of liver function (Alanine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP)) were assessed. Further, total iron content of the liver and spleen was quantified using a using Perls' staining for non-heme ferric iron (Fe3+). The mean Hb at baseline for this cohort was 10.5 g/dL, Hct was 36% and RBC count was 7.6 10 6/ µL. After treatment with apoHb-Hp complex for 6 weeks, Hb levels improved to 11.3 g/dL and Hct to 38% vs. Hb of 10.1 g/dL and Hct of 35% for vehicle treated animals. The mean total RBC count at was 9.2 10 6/ µL following treatment with apoHb-Hp, and 7.7 10 6/ µL for vehicle treated animals at 6 weeks. Iron parameters were also improved, with lower mean serum iron levels in the apoHb-Hp treated group at 6 weeks when compared to vehicle control (90.5 µg/dL vs. 135.2 µg/dL, p < 0.05). Serum transferrin levels were 131.1 mg/dL vs. 90.3 mg/dL (p<0.05) for the apoHb-Hp and vehicle treated groups at 6 weeks respectively. Furthermore, when compared to control mice, apoHb-Hp mice had a significant reduction in both liver and spleen weights at 6 weeks- liver 5.7g vs. 5.2g (p<0.05) and spleen 3.8g vs. 3.4g (p<0.05) respectively. Finally, liver function tests also showed improvement following treatment with apoHb-Hp at 6 weeks, ALT 71.1 units/L vs. 85.5 units/L for the vehicle, AST levels 180.2 units/L vs. 217.6 for the vehicle (p <0.05) of, and ALP levels 247.3 units/L vs. 304.4 units/L (p <0.05). Our study demonstrates that apoHb-Hp can improve anemia and reduce iron toxicity in TI mice as well as improve liver and spleen parameters. Thus, apoHb-Hp may be a potential treatment strategy in this disease and merits further study. Figure 1 Figure 1. Disclosures Gopal: Alexion: Speakers Bureau; GBT: Consultancy; Pharming: Consultancy; Rigel Pharmaceuticals: Other: Clinical Trial, Research Funding.