ABSTRACT
Context: Z score defines the shift of an observed value from the mean. Aims: By determining the direction of this shift and its absolute value for mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), one can quickly screen the hemogram for any spurious results in RBC parameters and also predict the type of anemia. This is because MCH and MCHC are derived parameters (from Hb, RBC, MCV) and thereby reflect the true as well as false changes in an erythrogram. Materials and Methods: A total of 975 hemograms were studied retrospectively. Basic statistical formulae using mean and standard deviation were applied to calculate z scores for MCH and MCHC. Results obtained were compared with the standard method and validated by an independent cohort of 100 random samples run on a different machine. Results and Statistical Analysis: Z score was found to be statistically significant (p <.001) in diagnosing iron deficiency anemias, megaloblastic anemias, hemolytic anemias, regenerative anemias, anemia of chronic disease and spurious findings. Z score was not significant (p = 0.9) in predicting beta thalassemia trait. The sensitivity was low for the differentials of microcytic hypochromic anemias. Conclusions: Despite this, Z score can be of immense help to the clinicians and pathologists in making quick interpretation of the underlying red cell abnormalities. Also, it can be used as a quality assessment tool in hematology laboratories taking pre analytical and analytical factors into account.
ABSTRACT
Anaemia is a disease of low erythrocyte count and haemoglobin (Hb) concentration less than the normal range. The main causes of anaemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anaemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anaemia. In general, microcytic hypochromic anaemias are caused by reduced haemoglobin synthesis (most commonly because of iron deficiency), while macrocytic anaemias caused by reduced DNA synthesis that impair the maturation of erythroid precursors in the bone marrow. Normocytic normochromic anaemias have diverse aetiologies; in some of these anaemias, specific abnormalities of red cell size and shape which is best appreciated through visual inspection of peripheral smears provide an important clue as to cause.METHODSRetrospectively and prospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anaemic patients attending during the year 2018 (from 1st January to 31st December), in the Department of Pathology, Gandhi Medical College, Bhopal (M.P.).RESULTSOut of a total of 500 patients, 220 were males and 280 were females. Results of CBC and PBP showed that 145 (29%), 275 (55%) and 80 (18%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anaemia respectively.CONCLUSIONSThe microcytic hypochromic pattern of anaemia is highly frequent among this sample of patients while the macrocytic pattern of anaemia is the lowest. According to gender groups, microcytic hypochromic pattern of anaemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic anaemia is highly prevalent among males, which is mainly due to blood loss or chronic diseases.
ABSTRACT
The objective of this study was to measure the effects of glucose and salt level on white blood cells, red blood cells and platelets (PLTs) in the blood of a leukemic patient by using a white light microscope. Different concentrations of glucose and salt in the range of 0 mM to 500 mM were admixed in the blood sample to prepare blood smear. We revealed that shape of erythrocytes, leukocytes and platelets changes and form aggregates. Increasing concentrations of glucose cause to increases aggregation process of white blood cells, red blood cells and platelets. And the increasing concentration of sodium chloride causes to increase rouleaux formation and aggregation of platelets but dehydration due to increased sodium chloride concentration causes to break the aggregation of white blood cells. Comparison of CBC reports of these samples with and without analytes shows that total leukocyte count (TLC) decreases gradually towards normal ranges of leukocytes which is favorable in the treatment of leukemia but at the same time decreasing level of hemoglobin HGB, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and increasing level of red blood cell (RBCs) causes to reduce oxygen supply which is in favor of cancer growth and anemia. This work provides us the base for translation this in vitro study towards the in vivo case of blood microvasculature as a non-invasive methodology.
O objetivo deste estudo foi medir os efeitos da glicose e do nível de sal nos glóbulos brancos, glóbulos vermelhos e plaquetas (PLTs) no sangue de um paciente leucêmico usando um microscópio de luz branca. Foram misturadas diferentes concentrações de glicose e sal na gama de 0 mM a 500 mM na amostra de sangue para preparar esfregaço de sangue. Descrevemos que a forma dos eritrócitos, leucócitos e plaquetas muda e forma agregados. O aumento das concentrações de glicose aumenta o processo de agregação de glóbulos brancos, glóbulos vermelhos e plaquetas. E a crescente concentração de cloreto de sódio causa o aumento da formação de rouleaux e a agregação de plaquetas, mas a desidratação devido ao aumento da concentração de cloreto de sódio causa a quebra da agregação de glóbulos brancos. A comparação dos relatórios de CBC dessas amostras com e sem analitos mostra que a contagem total de leucócitos (TLC) diminui gradualmente para os intervalos normais de leucócitos, o que é favorável no tratamento da leucemia, mas ao mesmo tempo diminui o nível de hemoglobina HGB, hemoglobina corpuscular média (MCH ), a concentração média de hemoglobina corpuscular (MCHC) e o aumento do nível de glóbulos vermelhos (RBCs) reduz o suprimento de oxigênio, o que é a favor do crescimento do câncer e da anemia. Este trabalho fornece a base para a tradução deste estudo in vitro para o caso in vivo de microvasculatura de sangue como uma metodologia não-invasiva.
Subject(s)
Leukemia , Erythrocytes , Leukocytes , Microscopy , Blood Cell Count , Blood Glucose , Sodium Chloride , Erythrocyte Indices , Leukocyte CountABSTRACT
Background@#Anemia is a major global problem that affects women and prevalent during pregnancy. Effective management is needed to prevent adverse maternal and pregnancy outcomes. Ferrous iron salts are the preparation of choice and recommended for both prevention and treatment of iron deficiency anemia (IDA). However, most commonly available iron supplement are poorly absorbed, with gastrointestinal disturbances as side effect.@*Objective@#To compare the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of IDA among pregnant women seen at the out-patient department of a tertiary medical center.@*Methodology@#This study is a single blind randomized clinical trial which included women 18 to 40 years old, with singleton pregnancies diagnosed with IDA without any co-existing fetal and maternal complications seen at the OutPatient Department. Forty eight eligible participants were randomized, with 24 women allocated on each treatment arm who took their assigned treatment twice a day for 90 days. Hemoglobin, hematocrit, MCHC, MCV, RDW & serum ferritin levels were taken at baseline and monitored on days 30, 60 and 90 from initiation of treatment. Mean blood parameters between two treatment arms were compared on days 30, 60 and 90 post-treatment as well as the mean difference of blood parameters on days post-treatment from the baseline using T-test. Chi-square was used to compare adverse effects between two treatment arms.@*Results@#No statistically significant differences in the mean blood parameters on days 30 and 60 of treatment between Iron amino acid chelate and Ferrous sulfate. It was only on day 90 from initiation of treatment when there were a significantly higher hematocrit and MCHC and lower RDW in Iron amino acid chelate compared to Ferrous sulfate group. All of the CBC parameters on days 30, 60, and 90 post-treatment when compared to baseline level were significantly increased for both treatment arms. However, day 90 level of serum ferritin in the Iron amino acid chelate group significantly increased unlike those in ferrous sulfate group.@*Conclusion@#Iron amino acid chelate is comparable to Ferrous sulfate in the treatment of IDA among pregnant women. Iron amino acid chelate was found to be superior to Ferrous sulfate in achieving optimum treatment response even at a lower dose with lesser adverse effects. Hence, better oral iron treatment tolerability, thereby, compliance to long-term therapy can be expected resulting to successful treatment outcome.
Subject(s)
Hemoglobins , HematocritABSTRACT
Background: The aim of this study was to find out the changes in blood parameters in a group of myocardial infarction patients in Jamnagar, Gujarat. Methods: In this cross sectional study conducted at the medicine clinic in GGH general hospital, Jamnagar between May 2012 and April 2013, a total of 100 subjects were included. Parameters like hemoglobin, RBC count, WBC count, platelet count, hematocrit, ESR, Mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, packed cell volume, differential WBC count used. Results: The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutrophil cells) in patients increased significantly (P <0.01) comparison to controls. While, the differential leukocyte count of lymphocyte & platelet count revealed to decrease significantly (P <0.01) in patients. Conclusion: Abnormal blood parameters are more common among diabetes patients. Elevated WBC count, ESR, neutrophils are present in patients as compared to control. While decreased in lymphocytes & platelets are seen in patients as compared to control.
ABSTRACT
The present study is aimed at ascertaining the effect of oral feeding of Cannabis sativa on blood parameters and immunity in rats. Administration of Cannabis sativa was done by orogastric feeding. All the groups had free access to water and food. The experiment lasted for 28 days. At the end of the 28 days of feeding, we observed that the mean red blood cell count was 5.68±0.09 x 106/mm3, 5.90±0.04 x 106 mm3 and 6.38 ±0.22 x 106 mm3 for control, low dose (LD) and high dose (HD) respectively. The red blood cells count in high dose was significantly higher (P<0.05) than low dose and control (P<0.01) respectively. However there was no significant difference between control and low dose. The total white blood cell count for control, LD and HD groups was 2.26±0.13 x 103/mm3, 1.69±0.04 x 103 mm3 and 1.58±0.09 x 103mm3 respectively. There was however no significant difference between the LD and HD even though both test groups were each significantly (P<0.001) lower than control. There was no significant difference in the pack cell volume (PCV) among the groups. The haemoglobin concentration (Hb) did not show any significant difference between LD and HD, but between the control and HD there was significantly higher (P<0.05) Hb concentration in HD. The mean platelet count for control, LD and HD were 252±14.94 x 103/mm3, 364±7.47 x 103/mm3 and 424±7.47 x 103/mm3 respectively. Both experimental group were each significantly higher (P<0.001) than control group. Platelet in the high dose was significantly higher (P<0.01) than in the low dose. In the differential count, the lymphocytes, monocytes and neutrophils were significantly (P<0.001) reduced in high and low dose groups when compared with control. Eosinophils and basophils increased significantly (P<0.001) in both high and low dose groups when compared with control. Mean corpuscular haemoglobin concentration (MCHC) showed a significant increase (P<0.05) in the high dose when compared with control but mean corpuscular Hb was unaffected.
ABSTRACT
Physical training induces beneficial adaptation, whereas exhaustive exercises increase reactive oxygen-species generation, thereby causing oxidative damage in plasma and erythrocytes, fractions susceptible to lipid peroxidation. Pequi (Caryocar brasiliense Camb.) is a Brazilian Cerrado fruit containing a carotenoid-rich oil. The aim was to investigate the effects of pequi-oil on exercise-induced oxidative damage in plasma and erythrocytes, after running in the same environment and undergoing weekly training under the same conditions as to type, intensity and length. Evaluations were accomplished after outdoor running on flat land before and after ingestion of 400 mg pequi-oil capsules for 14 days. Blood samples were taken after running and submitted to TBARS assay and erythrogram analysis. Haptoglobin, MnSOD (Val9Ala), CAT (21A/T) and GPX1 (Pro198Leu) gene polymorphisms were priorly investigated, so as to estimate genetic influence The reduction in erythrocytes, hemoglobin and hematocrit after pequi-oil treatment was notably associated with higher plasma expansion. Except for MCHC (mean corpuscular hemoglobin concentration) and RDW (red cell distribution width), the results were influenced by the polymorphisms studied. The best response to pequi-oil was presented by MnSOD Val/Val, CAT AA or AT genotypes and the GPX1 Pro allele. The significantly lower RDW and higher MHCH values were related to pequi-oil protective effects. Pequi oil, besides possessing other nutritional properties, showed protective blood effects.
ABSTRACT
La esferocitosis hereditaria es un grupo heterogéneo de desórdenes caracterizados por la variabilidad en la clínica, en los defectos proteicos del citoesqueleto eritrocitario y en el tipo de herencia. Se estudió la sensibilidad y especificidad de la concentración de hemoglobina corpuscular media (CHCM) y el índice de amplitud de distribución eritrocitaria (ADE) en el screening diagnóstico de la esferocitosis hereditaria. Noventa y cuatro pacientes fueron comparados con niños sanos de igual sexo y edad. Todos los índices se obtuvieron por impedancia eléctrica (autoanalizador hematológico Coulter JT). En los pacientes con esferocitosis hereditaria, la CHCM (35.67±1.33 g/dl) y el ADE (20.60±4.5%), fueron significativamente más elevados que en el grupo control (CHCM 33.48±0.68 g/dl, p 0.000; ADE 13.22±0.9%, p 0.000). Con los valores de corte utilizados en nuestro laboratorio (CHCM ≥ 34.5 g/dl; ADE ≥ 14.5%) ambos índices elevados mostraron una sensibilidad de 81% y una especificidad de 98.9% en el screening de esferocitosis hereditaria. La combinación de ambos índices es un excelente predictor para el diagnóstico de esferocitosis hereditaria.
Hereditary spherocytosis is a group of heterogenous disorders characterized by variability in its clinical manifestations, membrane protein defects and inheritance. We analysed the sensitivity and specificity of mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) in the diagnostic screening of hereditary spherocytosis. Ninetyfour patients were compared to equal number of healthy, age-matched children. All indexes were derived from measurements obtained by aperture impedance (Coulter Counter Model JT). In patients with hereditary spherocytosis, MCHC (35.67±1.33 g/dl) and RDW (20.60±4.5%) were significantly higher than in normal control subjects (MCHC 33.48±0.68 g/dl, p: 0.000; RDW 13.22±0.9%, p: 0.000). By using a cutoff for the MCHC of 34.5 g/dl and for the RDW of 14.5%, both indexes showed a sensitivity of 81% and a specificity of 98.9%. The combination of the two test is an excellent predictor for the diagnosis of hereditary spherocytosis.
Subject(s)
Child, Preschool , Female , Humans , Male , Erythrocyte Indices , Hemoglobins/analysis , Mass Screening/methods , Spherocytosis, Hereditary/blood , Confidence Intervals , Mass Screening/standards , Retrospective Studies , Sensitivity and Specificity , Spherocytosis, Hereditary/diagnosisABSTRACT
A interferência dos triglicerídeos plasmáticos sobre a determinação da hemoglobina foi observada em dosagens acima de 800 mg/dl, provavelmente devido ao aumento da turbidez. Este efeito espúrio leva a falsos resultados no cálculo da HCM e da CHCM. A substituição do plasma lipêmico por soluçäo salina corrige os resultados superestimados da hemoglobina, bem como permite obter resultados mais exatos no cálculo da HCM e da CHCM. (AU)
Plasma triglycerides interference on spectrophotometric hemoglobin determination wasobserved in blood samples with more than 800mg/dl, probably due to the turbidity increase. This spuriouseffect leads to false results in MCM and MCHC determination. Substituting saline solution for thelipaemic plasma corrects the overestimated hemoglobin determination as well as affording more accurateMCH and MCHC values. (AU)
Subject(s)
Plasma , Triglycerides , HemoglobinsABSTRACT
The purpose of this study Is whether we can presuppose the correlation between some type of anemia and exposure to organic solvents using some hematologic index such as MCV, RDW and MCHC. The authors conducted the hematological examination of 160 male workers who were exposed organic solvents and those of 167 control workers. The type of anemia was slightly macrocytic anemia, and the RDW was generally homogenous in workers exposed to organic solvents whereas those of control were normocytic and homogenous.
Subject(s)
Humans , Male , Anemia , Anemia, Macrocytic , SolventsABSTRACT
This study investigated the effects of vitamin C supplementation on the nutritional iron status of 31 adolescent girls, aged 12-15 years, with low hemoglobin levels. They were randomly divided into four groups, and for two groups daily150 mg or 900 mg of L-ascorbic acid(AsA) was given in three equal doses at three meals during 9 weeks. To another group daily 60 mg iron as ferrous sulfate was given in the same way as AsA. The control group was given sugar placebo. Body iron status was monitored through the determination of Hb, Hct, MCHC, and serum ferritin concentrations. Dietary AsA and iron intakes were measured from food consumption surveys performed by 3-day 24-hour recalls. The amount of absorbed iron was estimated from the model of Monsen et al. The average amounts of food iron for four groups were 12.3- 15.0 mg and 11.1 - 18.9 mg at initial and at final period of the supplementation trial, respectively. The tentatively estimated amount of absorbed iron was significantly increased in the 900 mg AsA and iron supplementing groups, but not in the 150 mg AsA and placebo groups. Both Hb and MCHC were improved to above normal levels in all groups except the placebo group. Hct was elevated only in the AsA 900 mg group whose Hct was relatively lower than the other groups. Serum ferritin concentrations of the four groups, which were as low as 8.50 - 14.39ng/mL on average at the intial periods, augmented significantly to 20.18ng/mL and 26.63ng/mL in the 900 mg AsA and iron groups, respectively. Serum ferritin was not elevated in either the AsA 300 mg group or the placebo group. The above data indicated that the daily supplementaion of 150 mg AsA to the meals containing 12-15 mg iron per day promoted Hb levels of adolescent girls with low Hb, and the 900 mg AsA supplementing improved not only Hb level but also body iron store. A supplementation of 60 mg iron per day appeared to be slightly more effective in improving the iron status in comparison to the 900 mg AsA supplement.
Subject(s)
Adolescent , Female , Humans , Ascorbic Acid , Ferritins , Iron , Meals , VitaminsABSTRACT
This study was undertaken on 120 healthy primary school children (male 60, female 60), who live in a fishing village, Geo-Mun island, Chulla-Namdo, in order to investigate normal value of red blood cell. Ages of the children were ranged from six years to twelve years. The author cheked the number of red blood cell, hemoglobin level, hematcrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), and mean corpuscular hemoglobin concentration(MCHC). MCV, MCH, and MCHC were calulated by formula of Wintrobe. The results obtained were as follows; 1. The mean value of RBC count was 4,500,000/mm3(range : 3,470,000-5,850,000/mm3) 2. The mean value of hemoglobin level was 12.5gm/dl(range: 11.0~14.0gm/dl). 3. The mean value of hematcrit was 37.0%(range: 32~42%). 4. The mean value of MCV was 83.5 cub. micron(range 71.0~105.3 cub. micron.) 5. The mean value of MCH was 28.3rr(range: 22.2~39.7rr). 6. The mean value of MCHC was 33.8gm/100ml (range: 32.4~35.9/100 ml).