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Due to the nature of their work, coal miners have historically faced significant exposure to large amounts of dust, placing them at a heightened risk. The present study was conducted to explore the hazardous effects of inhalation of coal dust on the haematological parameters of underground coal miners. 120 underground coal miners (60 workers having 5-10 years of experience and the other 60 having 10-20 years of experience) and 62 matched non-exposed to coal dust subjects as control from the locality were recruited for the study. After obtaining consent, different physiological parameters were measured, and blood was collected for assessment of haematological parameters. Observations revealed that there were lower mean values of total RBC count, haemoglobin level, MCV, PCV, MCHC and MCH in coal mine workers whereas mean values of Red Cell Distribution Width (RDW) and ESR were increased in the workers group. Further, coal dust exposure causes increased total leucocyte to count as well as a differential count of lymphocyte, neutrophil, monocyte, and eosinophil in the workers group but, a decreased differential count of basophils was detected among coal dust-exposed workers. All the changes in haematological parameters were found to occur experience-dependent and maximum changes were observed in workers having 10-20 years of working experience. There is a significant likelihood of coal mine workers experiencing changes in their blood composition, which suggests the harmful impact of coal dust on this group. Further, haematological parameters will help health professionals to screen any pathologic conditions and may help to prevent coal dust exposure-associated haematological disorders and complications thereof. [ABSTRACT FROM AUTHOR]

I provide here both my personal and scientific autobiography. After giving a background and summary of most of my research, I present information on my parents, my childhood, schooling, university education, and postdoctoral research, all in Australia. This is followed by a presentation of my life and research in Cambridge, UK and then at the Commonwealth Scientific and Industrial Research Organisation (CSIRO), in Australia, since 1955, where most of my research was done, especially on photosynthesis which included the following areas: Purification of a protochlorophyllide-protein complex; separation of the photochemical systems of photosynthesis; development of photochemical activity in photosynthesis; protein synthesis in plants; comparative photosynthesis of sun and shade plants; role of chlorophyll b in photosynthesis; photochemical properties of C4 plants; molecular interaction of thylakoid membranes; electron transport and ATP formation; and solar energy conversion in photosynthesis. In addition to research on the basics and applications of photosynthesis, I also mention at the end my service as a member of the executive of CSIRO. [ABSTRACT FROM AUTHOR]

Obi Peter Adigwe,1 Solomon Oloche Onoja,2 Godspower Onavbavba1 1Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria; 2Department of Medical Laboratory Sciences, University of Nigeria, Enugu, NigeriaCorrespondence: Obi Peter Adigwe, Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria, Email o.p.adigwe@niprd.gov.ngAbstract: Sickle cell disease is caused by an abnormality of the β-globin gene and is characterised by sickling of the red blood cells. Globally, sub-Saharan African countries share the highest burden of the disease. This study aimed at critically reviewing studies focusing on challenges of sickle cell anaemia in sub-Saharan Africa. A literature search was carried out in five major databases. Articles that met the inclusion criteria were included in the bibliometric review and critical analysis. A majority of the studies were undertaken in the West African region (85.5%), followed by Central Africa (9.1%). Very few studies had been undertaken in East Africa (3.6%), whilst the Southern African region had the fewest studies (1.8%). Distribution in relation to country revealed that three quarters of the studies were carried out in Nigeria (74.5%), followed by the Democratic Republic of the Congo (9.1%). According to healthcare settings, a strong majority of the studies were undertaken in tertiary health care facilities (92.7%). Major themes that emerged from the review include interventions, cost of treatment, and knowledge about sickle cell disease. Public health awareness and promotion as well as improving the quality of sickle cell centers for prompt management of patients with sickle cell disorder was identified as a critical strategy towards reducing the burden of the disease in sub-Saharan Africa. To achieve this, governments in countries located in this region need to adopt a proactive strategy in addressing gaps that have been identified in this study, as well as instituting other relevant measures, such as continuous media engagement and public health interventions relating to genetic counselling. Reforms in other areas that can help reduce the disease burden, include training of practitioners and equipping sickle cell disease treatment centers according to World Health Organization specifications.Keywords: sickle cell anaemia, interventions, haemoglobin, genotype, genetics

Introduction: During pregnancy, the need for iron increases, which triggers anemia. Anemia can be described as a decline in the hemoglobin level below a critical level. Meanwhile, based on a preliminary study, 10 out of 13 pregnant women were not obedient in taking iron tablets (76, 92%). The prevalence of anemia at Tanah Kalikedinding Community Health Center in 2015 remained high. Method: The analytical study used a cross-sectional design. The group of pregnant women in the third trimester who received Fe tablets and had their Hb levels checked at the Tanah Kalikedinding Health Center Surabaya were 54 people. The sampling technique chosen was total sampling. The instruments used were questionnaire sheets, data collection sheets, and survey software. Data analysis used the Fisher exact test. Result : Out of the 54 pregnant women, 20.4% of pregnant women were obedient to taking blood-supplement pills and experienced an increase in hemoglobin levels (63.3%), 70.6% of pregnant women were not adherent, and almost all of them had decreased their. The results of a bivariate analysis using Fisher's exact showed a significance value of p-value = 0.001

Acute Hepatic Porphyria (AHP) is an uncommon and hereditary illness that belongs to a group of disorders known as porphyries. This condition results from a deficiency of the porphobilinogen deaminase enzyme, which plays a role in heme production, a crucial component of haemoglobin in the bloodstream. This deficiency leads to the accumulation of substances called porphyrins in the body, which can trigger the appearance of severe and potentially life-threatening symptoms. In the following, we will discuss classifications - with a focus on the similarities and differences between subtypes of porphyria, the pathophysiology of acute hepatic porphyria, risk factors – and their influence on the onset of the disease, clinical manifestations, diagnosis, and management – both curative and symptomatic, all of which play a very important role in understanding this rare condition.

Abstract Background Most haematophagous organisms constantly suck the host’s haemoglobin, which produces toxic free haem. This toxic haem aggregation into the nontoxic crystallisation complex known as haemozoin represents one of the most important detoxification pathways in living organisms, but very little is known about the features of haemozoin in parasitic nematodes. Here, we identified and characterised the haemozoin of an economically significant blood-sucking nematode, Haemonchus contortus. Methods Using electron microscopy, spectrophotometry analyses and biochemical approaches, haemozoin crystallisation was identified and characterised in parasitic fourth-stage larvae (L4s) and/or adult worms as well as L4s of in vitro culture. Results The haemozoin was formed in intestinal lipid droplets of the parasitic L4s and adult worms. The characterisation of the haemozoin showed regularly spherical structures and had a 400-nm absorption peak. Furthermore, the haemozoin in in vitro cultured L4s was associated with the culture time and concentration of red blood cells added into the medium, and its formation could be inhibited by chloroquine-derived drugs. Conclusions This work provides detailed insight into the haemozoin formation of H. contortus and should have important implications for developing novel therapeutic targets against this parasite or related haematophagous organisms. Graphical abstract

Background: Pesticides are chemicals that have become common household products in developing countries. The purpose of pesticides is to manage agricultural work. The majority of pesticides for indoor and agricultural use are carbamate and organophosphorus. Toxicity is caused due to excess and improper use or disposal of these chemical agents. Slow exposure to pesticides causes chronic poisoning whereas rapid exposure causes acute poisoning. The paraoxonase I (PON 1) enzyme has a role in detoxifying some of the oxon derivatives which thereby inhibit acetylcholinesterase and butyrylcholinesterase. Methods: This study analyzed farmers who were exposed intermittently to organophosphorus and carbamates pesticides during farming for more than five years. Serum paraoxonase I was evaluated by colorimetry method, and hemoglobin levels were evaluated using portable Fresenius Kabi haemoglobinometer. Results: The study showed that the pesticides were found in the blood and urine samples of farmers and there was an alteration of paraoxonase I and hemoglobin levels in them due to the exposure of pesticides in large quantities over some time. The present study showed around 81% of the participants who were intermittently exposed to pesticides for more than five years were detected with pesticide toxicity. The paraoxonase I level was altered in farmers who were positive for organophosphorus and carbamate pesticides. The hemoglobin level did not show much variation among the farmers exposed to pesticides. This may be due to the lifestyle of the subjects, climatic variations and also their eating habits. Conclusions: The study suggested that there was alteration in the levels of PON1 and hemoglobin in farmers and agricultural workers with positive organophosphorus and carbamates in their blood and urine samples. As our study was done without quantifying the amount of pesticides, further studies can be done by quantifying the pesticide level and comparing it with the paraoxonase I level.

BackgroundExisting diagnostic methods for the parasitic gastrointestinal nematode, Haemonchus contortus, are time consuming and require specialised expertise, limiting their utility in the field. A practical, on-farm diagnostic tool could facilitate timely treatment decisions, thereby preventing losses in production and flock welfare. We previously demonstrated the ability of visible-near-infrared (Vis-NIR) spectroscopy to detect and quantify blood in sheep faeces with high accuracy. Here we report our investigation of whether variation in sheep type and environment affect the prediction accuracy of Vis-NIR spectroscopy in quantifying blood in faeces.MethodsVisible-NIR spectra were obtained from worm-free sheep faeces collected from different environments and sheep types in South Australia (SA) and New South Wales, Australia and spiked with various sheep blood concentrations. Spectra were analysed using principal component analysis (PCA), and calibration models were built around the haemoglobin (Hb) wavelength region (387-609 nm) using partial least squares regression. Models were used to predict Hb concentrations in spiked faeces from SA and naturally infected sheep faeces from Queensland (QLD). Samples from QLD were quantified using Hemastix® test strip and FAMACHA© diagnostic test scores.ResultsPrincipal component analysis showed that location, class of sheep and pooled versus individual samples were factors affecting the Hb predictions. The models successfully differentiated 'healthy' SA samples from those requiring anthelmintic treatment with moderate to good prediction accuracy (sensitivity 57-94%, specificity 44-79%). The models were not predictive for blood in the naturally infected QLD samples, which may be due in part to variability of faecal background and blood chemistry between samples, or the difference in validation methods used for blood quantification. PCA of the QLD samples, however, identified a difference between samples containing high and low quantities of blood.ConclusionThis study demonstrates the potential of Vis-NIR spectroscopy for estimating blood concentration in faeces from various types of sheep and environmental backgrounds. However, the calibration models developed here did not capture sufficient environmental variation to accurately predict Hb in faeces collected from environments different to those used in the calibration model. Consequently, it will be necessary to establish models that incorporate samples that are more representative of areas where H. contortus is endemic.

Poor iron status is detrimental to physical and cognitive performance in adolescents. Due to the limited studies investigating the association between iron status and physical fitness components in adolescents from low- and middle-income countries, we aimed to determine the association of iron status with selected physical fitness components in South African adolescents. A cross-sectional study design, including 178 adolescents (102 girls and 76 boys) from the Physical Activity and Health Longitudinal Study (PAHLS), was followed. Height and weight were measured to calculate the body mass index (BMI). Subsequently, WHO BMI-for-age-specific categorised body fatness. Cardiorespiratory fitness was determined with a 20-m shuttle run test (V˙O2max), and lower-body explosive power by the standing broad jump (SBJ). Fasting haemoglobin (Hb) and ferritin were analysed from blood samples. Correlation analyses determine the association between iron status, explosive power and cardiorespiratory fitness. Of the 178 participants, 18.5% (n = 33) had low Hb, and 14% (n = 25) iron deficiency without anaemia. Significant positive correlations were found between the selected physical fitness components, ferritin, and Hb. In boys, a positive association was found between Hb and SBJ (r = 0.30, p = 0.006), whilst in girls, positive associations were found between ferritin (r = 0.25, p = 0.04) and SBJ, and Hb with both SBJ (r = 0.21, p = 0.03) and V˙O2max (r = 0.32, p = 0.001). Hb concentration remained associated with V˙O2max and SBJ in girls after adjustment for age, whilst in boys, Hb concentration was associated with SBJ. Higher iron status in South African adolescents is associated with higher lower-limb explosive power and cardiorespiratory fitness. We suggest monitoring of haematological parameters, and interventions to improve the iron status of South African adolescents.

В статье рассмотрены генетические основы гемоглобинопатий, методы и средства анализа для диагностики носителей гемоглобинопатий, молекулярные причины α-талассемии, молекулярная основа и гетерогенность гемоглобинопатий на примере β-талассемии, а также промежуточная β-талассемия, связанная с дополнительными генами α-глобина. Гемоглобинопатии являются наиболее распространенными моногенными наследственными заболеваниями, создающими главную проблему здравоохранения во многих странах мира. Как показывает статистика, большинство гемоглобинопатий, носители рецессивного наследования и они обычно клинически бессимптомны. Программы пре-концепционного и антенатального скрининга на носительство с возможностью пренатальной диагностики считаются результативными во многих эндемичных странах. С развитием генетических инструментов исследования следующего поколения, таких как матричный анализ и секвенирование, в дополнение к современному скринингу на гематологическом, биохимическом и генетическом уровне, было обнаружено все большее число редких перестроек и новых факторов, влияющих на тяжесть заболевания за последние годы. В обзоре обобщены основные требования к адекватному скрининговому анализу носителей болезни, важность корреляции генотип-фенотип и то, как это может привести к не выявленным исключительным взаимодействиям, вызывающим клинически более тяжелый фенотип у бессимптомных носителей.

Introduction: Bone marrow investigations are crucial for Chronic Kidney Disease (CKD) patients with anaemia because they monitor iron stores and reveal morphological abnormalities. In the context of CKD, the examination of bone marrow plays a crucial role in assessing iron levels in individuals with anaemia, as well as providing valuable insights into the specific morphological alterations that occur in CKD patients. Aim: To determine the bone marrow changes and bone marrow iron storage in the patients with CKD; and to study the association between haematological parameters and different CKD stages. Materials and Methods: This cross-sectional study design enrolled 50 CKD patients in the Department of Pathology at MLB Medical College, Jhansi, Uttar Pradesh, India from December 2021 to November 2022. Each patient underwent bone marrow biopsy examination. The Medonic-M Series, an automated haematological analyser, performed the Complete Blood Count (CBC) with red cell indices. Perl’s staining and the Gale Grading Systems were used for assessing iron storage. Descriptive analysis employed frequency and proportions for categorical variables, while mean and Standard Deviation (SD) were used for continuous variables. One-way ANOVA was used to compare differences between variables. Data was collected, compiled, tabulated, entered into a Microsoft Excel sheet, and analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: The study included 50 cases, with the majority of patients being in their fifth and sixth decades of life. Of the total cases, 28 (56%) were males and 22 (44%) were females. Most patients were in Stage-V CKD (N=28, 56%), followed by Stage-III (N=16, 32%), and Stage-IV (N=6, 12%). Among the haematological variables, the difference in Haemoglobin (Hb) was statistically significant (p-value=0.001) in all CKD stages. Iron absorption was found to be normal in 58% (n=29) of patients and increased in 32.00% (n=16) of cases. A total of 26 (52%) out of 50 CKD patients had normocellular bone marrow biopsy and bone marrow smears. Conclusion: Bone marrow examination is undervalued but may be beneficial for CKD patients with anaemia, erythropoietin resistance, thrombocytopenia, or pancytopenia. This method should be considered in centres, whenever possible.

Introduction: One of the primary responsibilities of the blood bank is to provide safe blood to patients. Blood donors are screened before blood donation and deferred from donating if they have diseases or conditions that may affect blood quality or lead to adverse reactions. Blood donor deferral ensures both donor and patient safety. Understanding deferral reasons can help raise awareness among blood donors. Aim: To determine the percentage of female blood donors and the number of deferrals in male and female donors for various reasons. Materials and Methods: This retrospective cross-sectional study was conducted at Department of Transfusion Medicine, Government Medical college, Kozhikode, Kerala, India. The study period was one year from April 2018 to March 2019. Data on the number of male and female donors, donors accepted for donation, and those deferred for various reasons were collected through questionnaires and blood bank records. Data analysis was performed using Stastistical Packages of Social Sciences (SPSS) version 17.0 software, employing the Chi-square test with a significance level of p

Background: Pesticides are chemicals that have become common household products in developing countries. The purpose of pesticides is to manage agricultural work. The majority of pesticides for indoor and agricultural use are carbamate and organophosphorus. Toxicity is caused due to excess and improper use or disposal of these chemical agents. Slow exposure to pesticides causes chronic poisoning whereas rapid exposure causes acute poisoning. The paraoxonase I (PON 1) enzyme has a role in detoxifying some of the oxon derivatives which thereby inhibit acetylcholinesterase and butyrylcholinesterase. Methods: This study analyzed farmers who were exposed intermittently to organophosphorus and carbamates pesticides during farming for more than five years. Serum paraoxonase I was evaluated by colorimetry method, and hemoglobin levels were evaluated using portable Fresenius Kabi haemoglobinometer. Results: The study showed that the pesticides were found in the blood and urine samples of farmers and there was an alteration of paraoxonase I and hemoglobin levels in them due to the exposure of pesticides in large quantities over some time. The present study showed around 81% of the participants who were intermittently exposed to pesticides for more than five years were detected with pesticide toxicity. The paraoxonase I level was altered in farmers who were positive for organophosphorus and carbamate pesticides. The hemoglobin level did not show much variation among the farmers exposed to pesticides. This may be due to the lifestyle of the subjects, climatic variations and also their eating habits. Conclusions: The study suggested that there was alteration in the levels of PON1 and hemoglobin in farmers and agricultural workers with positive organophosphorus and carbamates in their blood and urine samples. As our study was done without quantifying the amount of pesticides, further studies can be done by quantifying the pesticide level and comparing it with the paraoxonase I level.

Background: Sickle cell anaemia (HbSS) is a major public health problem in Sub-Saharan Africa and commonly affects the spleen, with associated increased morbidity and mortality. This study aimed to evaluate the ultrasonographic findings of the spleen in patients with HbSS in steady state and to compare findings with those of individuals with normal adult haemoglobin (HbAA). Methods: This was a cross-sectional comparative study. Haemoglobin phenotypes were determined using haemoglobin electrophoresis. The spleen was scanned using transabdominal ultrasonography. Splenic size and parenchymal echotexture were assessed. Data was analysed with SPSS software, version 20. Results: One-hundred-and-twenty participants were recruited for the study, made up of 60 patients with HbSS and 60 age-and-sex-matched individuals with HbAA. They were made up of 54 (45%) males and 66 (55%) females, aged 2 to 32years, with mean age of 15.78 ±7.2 years for HbSS and 15.80 ±7.5years for HbAA participants. Thirteen (21.7%) patients with HbSS had autosplenectomy, 7 (11.7%) had splenomegaly, 6 (10%) had shrunken spleens, while 34 (56.7%) had normal sized spleens. All the participants with HbAA had normal splenic size with age. Of the 47 patients with HbSS whose spleen were visualized, 20 (42.6%) had abnormal splenic echotexture, whereas all the 60 (100%) participants with HbAA, had normal echotexture. There was significant difference in splenic echotexture in patients with HbSS compared to those with HbAA (p

Background: Preoperative anaemia is associated with increased use of blood transfusions, a greater risk of postoperative complications, and patient morbidity. The IRON NOF trial aimed to investigate whether the administration of i.v. iron in anaemic patients during hip fracture surgery reduced the need for blood transfusion and improved patient outcomes. Methods: This phase III double-blind, randomised, placebo-controlled trial included patients >60 yr old with preoperative anaemia undergoing surgery for femoral neck or subtrochanteric fracture across seven Australian Hospitals. Patients were randomly allocated on a 1:1 basis to receive either i.v. iron carboxymaltose 1000 mg or placebo (saline) at operation. The primary endpoint was blood transfusion use, with secondary endpoints of haemoglobin concentration at 6 weeks, length of hospital stay, rehabilitation duration to discharge, and 6-month mortality. Subgroup analysis compared outcomes in patients 80 yr old. All analyses were performed by intention-to-treat. This trial was terminated early because of jurisdictional changes of more restrictive transfusion practices and changes in consent requirements. Results: Participants (n=143) were recruited between February 2013 and May 2017. There was no difference observed in the incidence of blood transfusion between the treatment group (18/70) (26%) compared with the placebo group (27/73) (37%) (odds ratio for transfusion if receiving placebo: 1.70; 95% confidence interval [CI] 0.83–3.47; P=0.15) and there was no overall difference in the median number of blood units transfused between groups (odds ratio 1.52; 95% CI 0.77–3.00; P=0.22). Patients receiving i.v. iron had a higher haemoglobin 6 weeks after intervention compared with the placebo group (Hb 116 g L−1 vs 108 g L−1; P=0.01). No difference was observed in length of hospital stay, rehabilitation duration to discharge, or 6-month mortality. However, in younger patients without major bleeding, the use of placebo compared with i.v. iron was associated with an increased number of units of blood transfused (placebo transfusion incidence rate ratio 3.88; 95% CI 1.16–13.0; P=0.03). Conclusions: In anaemic patients undergoing surgery for hip fracture, i.v. iron did not reduce the overall proportion of patients receiving blood transfusion. The use of i.v. iron may reduce the amount of blood transfused in younger patients. The use of i.v. iron is associated with increased haemoglobin concentrations 6 weeks after the operation. Clinical trial registration: ACTRN12612000448842.

Background: Obesity is associated with type 2 diabetes mellitus and chronic low-grade inflammation. Although chronic inflammatory conditions and diabetes are associated with anaemia, less is known about associations of obesity and body shape, independent of each other, with erythrocyte and reticulocyte parameters. Methods: We investigated the associations of body mass index (BMI) and the allometric body shape index (ABSI) and hip index (HI), which are uncorrelated with BMI, with erythrocyte and reticulocyte parameters (all continuous, on a standard deviation (SD) scale) in UK Biobank participants without known metabolic, endocrine, or major inflammatory conditions (glycated haemoglobin HbA1c < 48 mmol/mol, C-reactive protein CRP < 10 mg/L). We examined erythrocyte count, total reticulocyte count and percent, immature reticulocyte count and fraction (IRF), haemoglobin, haematocrit, mean corpuscular haemoglobin mass (MCH) and concentration (MCHC), mean corpuscular and reticulocyte volumes (MCV, MRV), and red cell distribution width (RDW) in multivariable linear regression models. We additionally defined body shape phenotypes with dichotomised ABSI (≥ 73 women; ≥ 80 men) and HI (≥ 64 women; ≥ 49 men), including "pear" (small-ABSI-large-HI) and "apple" (large-ABSI-small-HI), and examined these in groups according to BMI (18.5–25 normal weight; 25–30 overweight; 30–45 kg/m2 obese). Results: In 105,853 women and 100,854 men, BMI and ABSI were associated positively with haemoglobin, haematocrit, and erythrocyte count, and more strongly with total reticulocyte count and percent, immature reticulocyte count and IRF. HI was associated inversely with all, but least with IRF. Associations were comparable in women and men. In groups according to obesity and body shape, erythrocyte count was ~ 0.6 SD higher for obese-"apple" compared to normal-weight-"pear" phenotype (SD = 0.31*1012/L women, SD = 0.34*1012/L men), total reticulocyte count was ~ 1.1 SD higher (SD = 21.1*109/L women, SD = 23.6*109/L men), immature reticulocyte count was ~ 1.2 SD higher (SD = 7.9*109/L women, SD = 8.8*109/L men), total reticulocyte percent was ~ 1.0 SD higher (SD = 0.48% women and men), and IFR was over 0.7 SD higher (SD = 5.7% women and men). BMI but not ABSI or HI was associated more weakly inversely with MCV, MRV, and MCH, but positively with MCHC in men and RDW in women. Conclusions: In obesity uncomplicated with diabetes, larger BMI and ABSI are associated with increased erythropoiesis and reticulocyte immaturity. [ABSTRACT FROM AUTHOR]

Introduction: Helicobacter pylori (H. pylori) is predominantly responsible for acute and chronic progressive gastroduodenal inflammation. Symptoms of gastric diseases vary from dyspepsia to altered bowel movements, leading to ulcers and potential gastrointestinal bleeding. Consequently, H. pylori can have a variable effect on the gastrointestinal tract and other organs. Ongoing research has shown associations between H. pylori and haematological manifestations. Recent studies have reported a 90% incidence of duodenal ulcers and an 80% incidence of gastric ulcers in patients with H. pylori infection. Aim: To investigate haematological manifestations in H. pyloriinfected patients with and without ulcers, and to compare the haematological variables. Materials and Methods: This cross-sectional study was conducted in the Department of Gastroenterology at King George's Medical University in Lucknow, India, from October 2021 to October 2022. One hundred patients diagnosed with H. pylori-positive biopsy through endoscopy were enrolled in the study. Among these patients, 51% had ulcers with H. pylori infection (enrolled as cases), while 49% were H. pylori infected but without ulcers (enrolled as controls). Samples were analysed for Haemoglobin (Hb) levels, Red Blood Cell (RBC) count, Reticulocyte Count (RetC), serum iron, serum ferritin, Total Iron Binding Capacity (TIBC), serum vitamin B12, and Homocysteine (HCy) levels. Statistical analysis involved independent sample t-tests to compare continuous data and chi-square tests to compare categorical data. Results: The majority of patients included in the study, both with ulcers (70.6%) and without ulcers (59.2%), were males with mean±Standard Deviation (SD) ages of 32.39±7.25 years and 29.86±7.66 years, respectively. In the present study, low reticulocyte count, anaemia, deranged RBC count, low serum iron, high TIBC, and low ferritin were observed in 9%, 22%, 61%, 11%, 12%, and 8% of the patients, respectively. Vitamin B12 deficiency and hyperhomocysteinemia were observed in 6% and 1% of the cases, respectively. Among patients with ulcers, the strongest correlation was found between serum iron and serum ferritin (r-value=0.901), while the weakest correlation was found between vitamin B12 and RetC (r-value=0.206). Among patients without ulcers, the strongest correlation was found between serum iron and Hb (r-value=0.884), while the weakest correlation was found between TIBC and HCy (r-value=0.270). Conclusion: The present study demonstrates a significant association between H. pylori infection-induced ulcers and decreased mean reticulocyte count, serum iron, and serum ferritin levels. Recognising these haematological derangements and including them as indications for H. pylori eradication may lead to a remarkable improvement in the management regime. [ABSTRACT FROM AUTHOR]

Background and Objectives: It is important to get the right amount of nutrition during adolescence because there are significant growth changes during this time. Undernutrition and iron deficiency anemia are the two main nutritional issues affecting the adolescent population, among other things. To find out how common anemia is in adolescent girls in the Kakatiya Medical College Warangal, AP urban field practice area. to identify various socio-demographic elements that affect adolescent girls' anemia. Methods: A cross-sectional study was conducted in three areas that were part of the Warangal, Kakatiya Medical College's urban health center, which serves as a field practice area. Between November 2021 and October 2022, the study was carried out. 350 teenage girls (aged 10 to 19) in total were enrolled in the study. To gather information about the socio-demographic variables, a pre-designed and pre-tested proforma was used. Each participant underwent a pertinent clinical examination. With the help of cyanomethemoglobin, hemoglobin was estimated. When the hemoglobin level fell below 12 gm/dl, anaemia was determined to be the cause. Results: Anaemia was prevalent in 81.1% of the population, with mild anemia accounting for 36.9%, moderate anemia for 40.9%, and severe anemia for 3.4%. When compared to late adolescents (15-19 years old), it was found that early adolescents (10-14 years old) had a higher prevalence of anemia. Most of the girls were moderately anemic. Girls living in hostels with working mothers and illiterate fathers were significantly more likely to have anemia than non-hostel residents. Conclusion: It was discovered that adolescent girls had a high prevalence of anemia, which was particularly high in the early adolescents. Anemia and father's educational background and employment status were significantly correlated. Giddiness and anemia were strongly correlated. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) can be produced from red blood cells (RBCs) on a large scale and used to deliver therapeutic payloads efficiently. However, not much is known about the native biological properties of RBCEVs. Here, we demonstrate that RBCEVs are primarily taken up by macrophages and monocytes. This uptake is an active process, mediated mainly by endocytosis. Incubation of CD14+ monocytes with RBCEVs induces their differentiation into macrophages with an Mheme‐like phenotype, characterized by upregulation of heme oxygenase‐1 (HO‐1) and the ATP‐binding cassette transporter ABCG1. Moreover, macrophages that take up RBCEVs exhibit a reduction in surface CD86 and decreased secretion of TNF‐α under inflammatory stimulation. The upregulation of HO‐1 is attributed to heme derived from haemoglobin in RBCEVs. Heme is released from internalized RBCEVs in late endosomes and lysosomes via the heme transporter, HRG1. Consequently, RBCEVs exhibit the ability to attenuate foam cell formation from oxidized low‐density lipoproteins (oxLDL)‐treated macrophages in vitro and reduce atherosclerotic lesions in ApoE knockout mice on a high‐fat diet. In summary, our study reveals the uptake mechanism of RBCEVs and their delivery of heme to macrophages, suggesting the potential application of RBCEVs in the treatment of atherosclerosis. [ABSTRACT FROM AUTHOR]

The goal of this study, which was conducted with the patients' prior informed consent, was to determine the levels of hemoglobin and hematocrit in adult patients treated at Salah Aldin Teaching Hospital (SUTH)City, Iraq, from December 2021 to February 2022. There were 61 blood samples collected from the finger pad, and they were all used. Haematocrit and hemoglobin's biochemical composition were determined using the cyanmethemoglobin method and centrifugation. According to the findings, women accounted for 83.6% of the total number of patients, while men made up the remaining patients. Only 11.5% of all patients have low hemoglobin levels, while 83.6% have normal hemoglobin levels. As a result, it is also specified that 90.2% of all patients have normal hematocrit values, while 1.6% of all patients have lower-than-normal hematocrit values. Furthermore, it was discovered that 3.3% of people are overweight. The χ2 statistical test was used to determine whether there is a significant relationship between the variables BMI, age, and gender. The test results revealed no significant relationship between these variables (p > 0.05). It can be concluded that age, gender, and BMI have no effect on hemoglobin and hematocrit levels. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency (ID) and anaemia of inflammation (AI) coexist where infections and nutritional deficiencies are common. The aim of this study was to determine burden of ID, anaemia, inflammation and AI in children in malaria endemic Limbe, Mount Cameroon as well as decipher the contribution of some inflammatory cytokines on the concentration of haemoglobin and ferritin. Methods: A total of 520 children aged ≤ 15 years old from the Limbe Health District (LHD) were randomly selected and examined in a cross-sectional study for iron deficiency, anaemia, inflammation and inflammation anaemia. Collected blood samples were used for full blood count and inflammatory marker analyses with the aid of a haemoanalyzer and ELISA machine, respectively. Spearman's rank correlation analysis was used to determine the correlation between cytokines and haemoglobin while multiple linear regression analysis was used to evaluate the effects of inflammatory cytokines on haemoglobin and ferritin concentrations. Results: The overall prevalence of anaemia, ID, IDA, inflammation and AI were respectively, 67.5%, 34.6%, 12.9%, 63.1% and 30.2%. Children aged 12‒15 years (P = 0.001), enrolled from the community (P < 0.001), whose parents are civil servants (P < 0.001), living in a home with 6‒10 occupants (P = 0.016), afebrile (P < 0.001) and malaria negative (P = 0.007) had the highest prevalence of ID while, children ≤ 5 years old (P = 0.001), with a family size of 1‒5 occupants (P = 0.033) had the highest prevalence of AI. Haemoglobin concentration positively correlated with concentrations of IFN-γ (P < 0.001), TNF-α (0.045) and ferritin (P < 0.001) while a negative correlation was observed with IL-10 (P = 0.003). In the multiple linear regression analysis only IL-6 significantly (P = 0.030) influenced haemoglobin concentration. Conclusions: While IL-6 is of significance in the pathology of anaemia, iron deficiency and anaemia of inflammation are of moderate public health concerns in the Mount Cameroon area. Hence, appropriate intervention against anaemia, ID and AI should be directed at children ≤ 5 years and counterparts > 10 years old that bear the highest burden. [ABSTRACT FROM AUTHOR]

Introduction: Extensive research has focused on emergency department (ED) and post-admission deaths, seeking to understand their frequency and causative factors. With the rising prevalence of advanced diseases, it is crucial to identify patients in need of end-of-life care and ensure its high quality. In this epidemiological study, we analyse routine ED blood tests to identify early warning signs of deteriorating patients with common non-traumatic and non-infectious (chronic) conditions. Material and methods: We conducted a retrospective single-centre study for the years 2016-2019 using medical records and electronic data from the Multi-Specialistic Hospital in Gorzów Wielkopolski, Poland. We examined 8971 unique patients with circulatory, neoplastic, and endocrine diseases. We assessed the impact of 2 grouping variables (survivors and non-survivors) on a continuous outcome variable, including age and 37 routine blood tests. Results: Two-way analysis of variance revealed that haemoglobin (Hb), haematocrit (Hct), and C-reactive protein (CRP) are the best differentiating biomarkers for early death in ED patients with cardiovascular, oncological, and endocrine diseases (excluding Hct due to its strong correlation with Hb). The Marczewski-Steinhaus taxonomy highlighted that oncological patients had the shortest survival time, averaging just 2 days from admission among ED non-survivors. Conclusions: Among routinely tested ED biomarkers, Hb and CRP levels are efficient at identifying neoplasms as the most common early mortality of chronic diseases in ED patients. [ABSTRACT FROM AUTHOR]

Key content: Postpartum haemorrhage accounts for 27% of all maternal deaths. Incorrect quantification of blood loss can lead to unnecessary interventions, such as the transfusion of blood products, which is not without risk.During pregnancy, cardiovascular changes may explain how blood loss can occur rapidly, with pregnant women tolerating large volumes of blood loss before a change in clinical signs is seen.Several methods are used to quantify blood loss, such as visual estimation, volumetric, gravimetric, colorimetric and photometric.The Obstetric Bleeding Strategy for Wales (OBS Cymru) project, which standardised management of obstetric haemorrhage in Wales using a four‐stage approach, showed a statistically significant improvement in outcomes.Different definitions of postpartum haemorrhage make it difficult to compare available evidence. Further studies are required combining the use of point‐of‐care tests and quantitative techniques to help improve morbidity and mortality associated with obstetric haemorrhage. Learning objectives: To understand the physiological changes in pregnancy and how they affect postpartum haemorrhage.To know the different available methods of quantifying blood loss.To review the point‐of‐care tests used to guide transfusion and management of postpartum haemorrhage. Ethical issues: Understanding the advantages and disadvantages of different methods of quantifying blood loss is essential to providing appropriate and safe care.Inaccuracy in measurement increases the risk of morbidity and mortality, in addition to complications of unnecessary treatments. [ABSTRACT FROM AUTHOR]

Predictable trait variation across environments suggests shared adaptive responses via repeated genetic evolution, phenotypic plasticity or both. Matching of trait–environment associations at phylogenetic and individual scales implies consistency between these processes. Alternatively, mismatch implies that evolutionary divergence has changed the rules of trait–environment covariation. Here we tested whether species adaptation alters elevational variation in blood traits. We measured blood for 1217 Andean hummingbirds of 77 species across a 4600‐m elevational gradient. Unexpectedly, elevational variation in haemoglobin concentration ([Hb]) was scale independent, suggesting that physics of gas exchange, rather than species differences, determines responses to changing oxygen pressure. However, mechanisms of [Hb] adjustment did show signals of species adaptation: Species at either low or high elevations adjusted cell size, whereas species at mid‐elevations adjusted cell number. This elevational variation in red blood cell number versus size suggests that genetic adaptation to high altitude has changed how these traits respond to shifts in oxygen availability. [ABSTRACT FROM AUTHOR]

Introduction: Febrile Seizures (FS) are the most common neurological disorders among infants and young children, occurring in 2%-5% of children younger than five years of age. Iron deficiency is reported as a commonest micronutrient deficiency, that has been associated with FS. Aim: To find out the cause of fever and the role of Iron Deficiency Anaemia (IDA) and its outcome in first FS in six months to six years of age. Materials and Methods: This was a hospital-based prospective observationa study, conducted in the Department of Paediatrics at King George Hospital, Visakhapatnam, Andhra Pradesh, India. The duration of the study was one year and seven months, from December 2019 to July 2021. A total of 130 children (six months-six years) were included in the study. A total of 65 cases had a febrile seizure and the rest 65 controls had a history of Febrile Illness (FI) without seizures. Anaemia was defined as the decrease of Haemoglobin (Hb)<11 gm%. Among the Red Blood Cells (RBC) indices Mean Corpuscular Volume (MCV) <70 femtoliters (fl), Mean Corpuscular Haemoglobin (MCH) <27 picograms (pg), plasma ferritin<12 µg/dL, and serum ferrous<60 µg/dL, Total Iron Binding Capacity (TIBC) >450 µg/dL, transferrin<250 mg. Discrete variables are expressed as counts (%) and compared using the Chi-square test, quantitative variables were expressed as mean and Standard Deviation (SD) and compared using t-test. and Statistical significance was set at p-value<0.05. Analysis was done using Statistical Package for Social Sciences (SPSS) version 22.0. Results: The mean age of the study participants (cases) was 2.57±1.5 years for cases and 2.56±1.35 years for controls. In the present study, male:female ratio was 1.24:1. In the present study, positive family history of seizures is an important risk factor for FS. The observations came 43 (66.2%) cases were IDA with FS 22 (33.8%) cases, were, with only FS 23 (35.4%) of controls were, with IDA and FI 42 (64.6%) of controls with the FI, which is statistically significant, p-value=0.001. Conclusion: IDA is one of the major risk factors for FS in the paediatric age group. Early identification and treatment of iron deficiency may prove helpful in preventing FS in paediatric patient. [ABSTRACT FROM AUTHOR]

Background Neonatal anemia contributes to the global burden of anemia, a crucial public health concern. It is primarily associated with mild to severe neurological impairment, which may result in perinatal mortality and morbidity. This study aimed to determine the prevalence of anemia and its association with sex and age in newborns at Al-Baha, Saudi Arabia. A retrospective observational study was performed using the R-studio/r-base coding tool. The analysis included the mean, standard deviation, median, interquartile range, correlation matrix, and logistic regression. The overall prevalence of neonatal anemia was 25.36% (n = 140). The mean±SD of hemoglobin (Hgb) (g/dl) was significantly different between anemic and nonanemic neonates, with values of 9.36 ± 1.04 and 15.74 ± 3.35 (P < 0.0001). The prevalence of neonatal anemia in males and females was 29.8% and 20.5%, respectively. Among males, the neonatal anemia Severity was 14.4% (mild anemia) and 6.1% (moderate anemia), while among females, it was 20.1% (mild anemia) and 9.7% (moderate anemia). In female neonates, the prevalence of microcytic, normocytic, and macrocytic anemia was 6.08%, 62.36%, and 31.56%, respectively. In contrast, the prevalence rate of microcytic, normocytic, and macrocytic anemia among male neonates, was 8.3%, 54.4%, and 29.07%, respectively. In females, only normocytic iron deficiency anemia was observed (55%), whereas the prevalence of normocytic iron deficiency anemia and microcytic iron deficiency anemia in males was 69% and 31%, respectively. Overall, iron deficiency anemia affected 65% of males. Compared with neonates aged 0-90 days, neonates aged 90-180 days have ~0.4 times more likelihood of developing neonatal anemia. Female sex is one of the risk factors associated with anemia. Further investigation and implementation of preventive measures are crucial to address the prevalence and severity of neonatal anemia. [ABSTRACT FROM AUTHOR]

Low birth weight (LBW) is an important determinant of mortality, morbidity and disability in the neonatal, infant and childhood period and has long-term implications for health in adulthood. The prevalence of LBW varies widely between countries, ranging from 7.2% in industrialised countries to 17.3% in Asia. In India, the prevalence of LBW has decreased from 20% to 16% in the last decade. A major reason for this improvement could be the improvement in maternal and child health care through specially designed programmes. This study was conducted in District Hospital, Panna, M.P., India, which has a well-equipped delivery room and operation theatre. The present study is based on the data collected from the birth register of District Hospital Panna, and shows that the prevalence of low birth weight (LBW) is 33.9%. Maternal age, duration of pregnancy, maternal health status, etc. were found to be associated with LBW. [ABSTRACT FROM AUTHOR]

Background: Anaemia (low haemoglobin [Hb]) is well known to be associated with high mortality and adverse cardiac events following surgical treatment of abdominal aortic aneurysm (AAA). However, little is known about the relationship of AAA volume and Hb level alterations with endovascular repair of AAA. This study aimed to examine the changes in the Hb level and aneurysm volume before and after endovascular aneurysm repair (EVAR) for AAA and determine the relationship between the post-operative Hb level and the volume loss of AAA. Methods: This retrospective study reviewed patients with AAA who underwent EVAR between January 2020 and February 2021 at a tertiary medical centre. The clinical features and medical history of the patients were analysed. Alterations in the Hb level were recorded, and the AAA volume was calculated from computed tomography angiography images before and after EVAR to infer the association between the post-operative Hb level and alterations in AAA volume. Moreover, AAA volume, pre-operative Hb level and medical history were studied to identify the risk factors for anaemia 24 h after EVAR. Results: A total of 74 patients (mean age, 67 ± 7.9 years) were included in this study. The Hb level decreased significantly 24 h after EVAR, and the post-operative Hb level was negatively correlated with AAA volume loss (r = -0.252, p = 0.041). No relationship was observed between AAA volume loss and decrease in the Hb level (r = 0.072, p = 0.571) or between pre-operative AAA volume and decrease in the Hb level (r = 0.072, p = 0.566). Furthermore, 59.5% of the patients (n = 44) developed anaemia 24 h after EVAR. The odds ratio (OR) of anaemia 24 h after EVAR was 5.3 times higher in those with hypertension (OR, 5.304; 95% confidence interval [CI], 1.024-27.424) than in those without the condition. The pre-operative Hb level (or normal Hb level) was a protective factor (OR = 0.909; 95% CI, 0.853-0.969). The area under the receiver operating characteristic curve was 0.840. The post-operative Hb level declined significantly, and AAA volume loss contributed to it. Moreover, hypertension was identified to be a risk factor for anaemia 24 h after EVAR, and pre-operative Hb level was discerned to be a protective factor. Conclusions: The findings suggest that decrease in the Hb level in the early post-EVAR stage warrants the attention of surgeons, especially in patients with a history of hypertension or a low pre-operative Hb level. [ABSTRACT FROM AUTHOR]

This work proposes an outstanding screening magneto-bioassay for the early identification of bovine subclinical mastitis. Haptoglobin (Hp) was used as a promising biomarker for the diagnosis of subclinical mastitis. To this end, novel chitosan-modified magnetic particles, coated with haemoglobin-modified polyaniline (MNPs@Chi/PANI-Hb), have been integrated in a sensitive electrochemical Hp bioassay. Haemoglobin was used as bioreceptor due to its high affinity against Hp. The appropriateness of their synthesis and their modifications were demonstrated by XRD, FT-IR spectroscopy, thermogravimetry and N2 adsorption–desorption analyses. After the optimization of the experimental parameters the main analytical features were obtained showing excellent performance. The electrochemical biosensor in milk matrix presented a dynamic range of 0.001 to 0.32 μg mL−1 with a detection limit of 0.031 μg mL−1, a value much lower than the normal Hp values in bovine milk, making it highly suitable for such determinations. Finally, real milk samples, obtained from local dairy farmers, were analysed by the electrochemical bioassay and compared against a commercial ELISA kit for Hp detection. Milk samples were correctly classified as "acceptable" or "unacceptable" milk considering the Hp concentration obtained with the proposed bioassay, confirming its excellent predictive capacity for subclinical mastitis diagnosis. [ABSTRACT FROM AUTHOR]

Haemolysis of erythrocytes upon exposure to haemato-toxic phenylhydrazine (PHZ), makes it an experimental model of anaemia and a partial model of β-thalassaemia, where oxidative stress (OS) was identified as principal causative factor. Oleic acid (OA) was evidenced to ameliorate such stress with antioxidative potential. Erythrocytes were incubated in vitro using 1 mM PHZ, 0.06 nM OA. Erythrocyte membrane protein densities and haemoglobin (Hb) status were examined. Any interaction of Hb with PHZ/OA was checked by calorimetric and spectroscopic analysis using pure molecules. Occurrence of erythrocyte apoptosis and involvement of free iron in all groups were evaluated. PHZ exposure to erythrocytes results in OS with subsequent apoptosis as evidenced from increased lipid peroxidation and translocation of phosphatidylserine in outer membrane. Preservations of erythrocyte cytoskeletal architecture and membrane bound enzyme activity were found in presence of OA. Moreover, both heme and globin of Hb was examined to be conserved by OA. Presence of OA, impeded apoptosis also, possibly by thwarting Hb breakdown followed by free iron release and consequent free radical generation. Additionally, direct sequential binding of OA with PHZ endorsed another protective mechanism of OA toward erythrocytes. OA affords protection to erythrocytes by conserving its major components and prevents haemolysis which project OA as a haemato-protective agent. Apart from combating PHZ toxicity, anti-apoptotic action of OA strongly suggests its usage in anaemia and β-thalassaemia patients to curb irreversible erythrocyte breakdown. This research strongly recommends OA in pure form or from dietary sources as a therapeutic against haemolytic disorders. [Display omitted] • Phenylhydrazine dismantles protein rich membrane and haemoglobin of erythrocytes. • Phenylhydrazine mediated oxidative stress instigates erythrocyte aging process. • Cytoskeletal architecture of erythrocyte membrane is preserved by oleic acid. • Oleic acid impedes free iron release followed by haemoglobin breakdown. • Oleic acid directly binds with phenylhydrazine to obstruct latter's action. [ABSTRACT FROM AUTHOR]

Summary: Patients with transfusion‐dependent β‐thalassaemia require lifelong, regular red blood cell transfusions for survival; however, frequent blood transfusions are associated with an increased risk of iron overload, transfusion‐transmitted disease and alloimmunization, as well as reduced quality of life. Luspatercept, an erythroid maturation agent that promotes late‐stage erythroid maturation independently of erythropoietin, has demonstrated efficacy in reducing transfusion burden in patients with transfusion‐dependent β‐thalassaemia. In this review, we discuss treatment initiation, ongoing evaluation, dose adjustment and management of adverse events in transfusion‐dependent patients with β‐thalassaemia receiving luspatercept, and we provide guidance on how to determine whether patients are deriving clinical benefit. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of combined use of pre-operative oral and post-operative intravenous (IV) tranexamic acid (TXA) as an effective blood conserving regimen in total knee arthroplasty (TKA) and compare its outcome with other modes of TXA administration. Patients and Methods: A prospective observational study was conducted on 25 patients with osteoarthritis knee undergoing TKA. Patients were given 1950 mg of oral TXA pre-operatively and 15 mg/kg of IV TXA post-operatively before tourniquet deflation. The outcome of the study in terms of peri-operative (intra-operative and post-operative) blood loss estimation, drain output, percentage fall in haemoglobin, and knee HSS scores pre-operatively and on subsequent follow-up were compared with the outcome of previous studies conducted in the same institution with intra-operative topical TXA administration, pre-operative oral TXA administration and without TXA administration. Results: The mean drain volume was 307.30 ± 148.00 ml and 22 (88%) patients had a drain volume less than 500 ml. The mean post-operative haemoglobin value was 10.53 ± 1.75 g/dl. It was observed that 18 (72%) of patients had up to 15% fall in haemoglobin. The mean percentage fall was 11.92%. In this study, 22 (88%) patients did not require any blood transfusion. Mean blood loss was 369.6 ± 159.96 ml. Maximum patients had less than 500 ml blood loss. No incidence of implant loosening, infection or wound gaping, clinically evident DVT/pulmonary thromboembolism was observed in the present study. We analysed total modified HSS knee score from pre-operative to 6 months follow-up using multi-group repeated measures analysis of variance (ANOVA), the difference in total modified HSS knee score between all the duration was observed to be highly significant (p < 0.001). Discussion: Combined administration of pre-operative oral and post-operative IV TXA is a safe and effective blood-conserving strategy in patients undergoing TKA along with the use of tourniquet. The outcome in terms of post-operative blood loss and drain output and the knee HSS score is comparable to the other modes of administration. [ABSTRACT FROM AUTHOR]

The unique teleost oxygenation system that permits enhanced oxygen unloading during stress comprises three main characteristics: pH-sensitive haemoglobin, red blood cell (RBC) intracellular pH (pHi) protection, and a heterogeneous distribution of plasma-accessible carbonic anhydrase (paCA). A heterogeneous distribution of paCA is essential; its presence permits enhanced oxygen unloading during stress, while its absence at the gills maintains conditions for oxygen uptake by pH-sensitive haemoglobins. We hypothesised that paCA would be absent in all four gill arches, as has been previously indicated for arch two, and that paCA would be present in all other tissues. Through a suite of biochemical and molecular methods, we confirmed the absence of paCA from all four arches. We also found evidence for paCA in nine other tissues and a lack of paCA availability in the stomach. Expression was highly variable between tissues and suggests these differences may be associated with their respective metabolic activities. Additionally, we analysed the specific CA-IV isoform expressed within each tissue and showed almost complete separation of expression between tissues; CA-IVa was detected in the heart, brain, anterior intestine, and liver, whereas CA-IVb was detected in all intestine sections, pyloric caeca, kidney, and white muscle. This adds to a growing collection of work suggesting CA-IVa and b play divergent roles in gas exchange and ion/acid–base balance, respectively. The current study represents the first comprehensive atlas of paCA availability within the circulatory system of the model teleost, rainbow trout, and fills important gaps in our knowledge of this unique oxygenation system. [ABSTRACT FROM AUTHOR]

Measures of nutritional status are often used as markers of health, at both individual- and population-level. Different measures of nutritional status – such as height or weight, for example, – may have different associations with health outcomes because they reflect both current nutritional status and the accumulation of past health experiences, but the weighting of past and present experiences differs between different measures. Here, we present an analysis of a longitudinal dataset, collected between 1950 and 1974 in four Gambian villages, to investigate whether three different measures – height, body mass index (BMI) or haemoglobin level – are associated with adult mortality. We interpret these different measures as indicators of different types of physical 'capital' that vary in their liquidity. Adult height represents 'illiquid' capital, indicative of nutritional status in the past, during different periods of development. BMI, determined both by past childhood experiences and recent nutrition and health exposures, represents capital of intermediate 'liquidity'. Haemoglobin represents 'liquid' capital, determined largely by recent environmental exposures. We find, not unexpectedly, that the more 'liquid' measures of capital show clearer associations with adult mortality: for haemoglobin there is a negative relationship with mortality risk for both sexes: BMI is also broadly negatively related to mortality risk for both men and women, though overweight individuals suffer a slightly increased risk of death. For men, there is no relationship between the 'illiquid' measure of height and adult mortality; but for women, there is a U-shaped relationship, with women of average height having the lowest mortality. [ABSTRACT FROM AUTHOR]

Introduction: Despite the clinical relevance and potential implications of anaemia in CLD, the available evidence regarding the association between anaemia and the severity of liver disease remains inconsistent and limited. Method: A cross sectional study was done among 116 CLD patients to address this research gap by investigating the prevalence, Etiology, and clinical implications of anemia among patients with CLD. Result: Out of total 116 patients, 57.8% had anemia. Among patients with anaemia, there were 56 males and 11 females. 71.2% (48) had mild anaemia, compared to 20.1% (14) and 20.1% (14) who had moderate and severe anaemia, respectively. 31 out of 67 (46.3%) were classified as CPS A and CPS B, and only 5 (7.4%) were classified as CPS C. When comparing patients with and without anaemia, the mean MELD points were 12.1 and 9.5, respectively. Conclusion: there was association found between anaemia and the severity of chronic liver disease, as indicated by higher MELD, and a higher proportion of patients in the more severe Child-Pugh scores categories with anaemia. [ABSTRACT FROM AUTHOR]

During prenatal life, the foetal liver is colonised by several waves of haematopoietic progenitors to act as the main haematopoietic organ. Single cell (sc) RNA-seq has been used to identify foetal liver cell types via their transcriptomic signature and to compare gene expression patterns as haematopoietic development proceeds. To obtain a refined single cell landscape of haematopoiesis in the foetal liver, we have generated a scRNA-seq dataset from a whole mouse E12.5 liver that includes a larger number of cells than prior datasets at this stage and was obtained without cell type preselection to include all liver cell populations. We combined mining of this dataset with that of previously published datasets at other developmental stages to follow transcriptional dynamics as well as the cell cycle state of developing haematopoietic lineages. Our findings corroborate several prior reports on the timing of liver colonisation by haematopoietic progenitors and the emergence of differentiated lineages and provide further molecular characterisation of each cell population. Extending these findings, we demonstrate the existence of a foetal intermediate haemoglobin profile in the mouse, similar to that previously identified in humans, and a previously unidentified population of primitive erythroid cells in the foetal liver. [ABSTRACT FROM AUTHOR]

Abstract Repeated maximal breath‐holds have been demonstrated to induce bradycardia, increase haematocrit and haemoglobin and prolong subsequent breath‐hold duration by 20%. Freedivers use non‐maximal breath‐hold techniques (BHTs) to improve breath‐hold duration. The aim of this study was to investigate the cardiorespiratory and haematological responses to various BHTs. Ten healthy men (34.5 ± 1.9 years) attended five randomized experimental trials and performed a 40 min period of quiet rest or one of three BHTs followed by a maximal breath‐hold challenge during facial immersion in water at 30 or 10°C. Cardiovascular and respiratory parameters were measured continuously using finger plethysmography and breath‐by‐breath gas analysis, respectively, and venous blood samples were collected throughout. Facial immersion in cold water caused marked bradycardia (74.1 vs. 50.2 beats/min after 40 s) but did not increase breath‐hold duration compared with warm water control conditions. Facial immersion breath‐hold duration was 30.8–43.3% greater than the control duration when preceded by BHTs that involved repeated breath‐holds of constant duration (P = 0.021), increasing duration (P 0.05). In conclusion, the duration of apnoea can be extended by manipulating blood gases through repeated prior breath‐holds, but changes in cardiac output and red blood cell mass do not appear essential.

Abstract Background In pig husbandry, most piglets receive an intramuscular injection with iron around three days of age for the prevention of hypochromic, microcytic anaemia. In recent years an increased interest is noted for needle-free injections, because of efficiency and safety for man and animal. This study aims to support the evidence on efficacy to extent the registration of a commercial iron supplement with a needle-free administration application. To this aim the study has two objectives: 1) to determine the effect of needle-free injection of the iron supplement on the mean blood Haemoglobin level at weaning, as primary outcome, and mean Haematocrit and mean Body weight of pigs at weaning as secondary outcome compared to no treatment, as main determinant of iron deficiency anaemia in piglets at time of weaning; 2) to compare the effects of needle-free administration of the iron supplement with regular injection by needle, with regard to the course over time of Haemoglobin, Haematocrit, piglet growth and the differentiated haematological and serum iron parameters. Methods A double blind randomized controlled trial was conducted with 72 piglets, 8 piglets per litter from 9 litters. At three days of age pigs were selected, based on body weight, and random allocated to three study groups: a) control non-treated group (2 pigs per litter, 18 in total), b) a group with regular iron injection by needle injection (3 pigs per litter, 27 in total), c) a group that received iron by needle-free injection (3 pigs per litter, 27 in total). At four points in time (day 3, 14, 26 and 40) piglets were weighed and bled to analyse the dynamics of red blood counts and haematological parameters as well as serum iron parameters. The primary outcome parameter was the Haemoglobin (Hb) level on day 26. Of secondary importance were Haematocrit (Ht) and body weight (BW) at weaning and parameters with tertiary importance were the course of Hb, Ht and differentiated red blood cell parameters, serum iron, iron binding capacity and iron saturation. In the statistical analyses, linear mixed effect regression modelling was used to account for repeated measures within litters and pigs. Results The analyses showed that needle-free administration was as efficacious to prevent iron deficiency anaemia at day 26 as administration using regular needle injection, compared to the control group. The mean level of Hb and Ht of pigs in the needle and needle-free group did not differ significantly. No side effects were observed. Conclusion It is concluded that needle-free iron administration of the tested product is as efficacious as regular administration by needle injection.

Abstract Objective Intracerebral hemorrhage (ICH) is the second most common subtype of stroke, with high mortality and morbidity. At present, there are no effective 6-month prognostic markers, particularly for younger patients. The aim of this research was to construct a new valuable prognostic nomogram model incorporating haemoglobin levels for adult patients with ICH. Methods Patients aged between 18 and 50 presenting with intracerebral haemorrhage at the Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between January 1st 2012 and December 31st 2018 were included in this retrospective study. Independent factors of prognosis were identified by univariate and multivariate logistic regression analyses, and a new nomogram model was constructed and validated. The clinical value of the nomogram model was subsequently explored utilizing decision curve analysis and clinical impact curves. Results In total, 565 patients were enrolled in this study, 117 (20.7%) of whom developed an unfavourable prognosis. Infratentorial lesion (adjusted odds ratio [aOR] = 3.708, 95% confidence interval [CI], 1.490–9.227; P = 0.005) was the most significant unfavourable outcome. Age ([aOR] = 1.054; 95% CI, 1.014–1.096; P = 0.008), hematoma volume (aOR = 1.014, 95% CI, 1.002–1.027; P = 0.024), haemoglobin (aOR = 0.981, 95% CI, 0.969–0.993; P = 0.002), blood glucose (aOR = 1.135, 95% CI, 1.037–1.241; P = 0.005) and NIHSS (aOR = 1.105, 95% CI, 1.069–1.141; P

In developing countries due to lack of sanitary practices, poor socioeconomic conditions and huge population burden, intestinal parasitic infections continue to be a major public health problem. The present study was done to determine the prevalence of Intestinal parasitic infections (IPI) among patients attending our tertiary care rural hospital. The study was conducted for a duration of 3 years at R L Jalappa Hospital and Research Centre, Kolar. Retrospective data of samples sent for stool microscopy were collected from laboratory records and were analyzed. During the study period, 62 out of 892 patients were screened positive for intestinal parasitic infections. The most common parasite observed was Entamoeba histolytica (5.3%) followed by Hookworm (1.2%), Ascaris lumbricoides (0.4%), Strongyloides stercoralis (0.1%), and Taenia species (0.1%). Findings of our study show that intestinal parasitic infections continue to be a burden, hence regular screening is essential to know the common parasites causing infections. Improved sanitation, safe drinking water practices, and health education are essential for prevention.

Abstract Background Electronic clinical decision support (CDS) within Electronic Health Records has been used to improve patient safety, including reducing unnecessary blood product transfusions. We assessed the effectiveness of CDS in controlling inappropriate red blood cell (RBC) and platelet transfusion in a large acute hospital and how speciality specific behaviours changed in response. Methods We used segmented linear regression of interrupted time series models to analyse the instantaneous and long term effect of introducing blood product electronic warnings to prescribers. We studied the impact on transfusions for patients in critical care (CC), haematology/oncology (HO) and elsewhere. Results In non-CC or HO, there was significant and sustained decrease in the numbers of RBC transfusions after introduction of alerts. In CC the alerts reduced transfusions but this was not sustained, and in HO there was no impact on RBC transfusion. For platelet transfusions outside of CC and HO, the introduction of alerts stopped a rising trend of administration of platelets above recommended targets. In CC, alerts reduced platelet transfusions, but in HO alerts had little impact on clinician prescribing. Conclusion The findings suggest that CDS can result in immediate change in user behaviour which is more obvious outside specialist settings of CC and HO. It is important that this is then sustained. In CC and HO, blood transfusion practices differ. CDS thus needs to take specific circumstances into account. In this case there are acceptable reasons to transfuse outside of these crude targets and CDS should take these into account.

Background Thalassaemia is one of the most common inherited monogenic diseases worldwide with a heavy global health burden. Considering its high prevalence in low and middle-income countries, a cheap, accurate and high-throughput screening test of thalassaemia prior to a more expensive confirmatory diagnostic test is urgently needed. Methods In this study, we constructed a machine learning model based on MALDI-TOF mass spectrometry quantification of haemoglobin chains in blood, and for the first time, evaluated its diagnostic efficacy in 674 thalassaemia (including both asymptomatic carriers and symptomatic patients) and control samples collected in three hospitals. Parameters related to haemoglobin imbalance (α-globin, β-globin, γ-globin, α/β and α-β) were used for feature selection before classification model construction with 8 machine learning methods in cohort 1 and further model efficiency validation in cohort 2. Results The logistic regression model with 5 haemoglobin peak features achieved good classification performance in validation cohort 2 (AUC 0.99, 95% CI 0.98–1, sensitivity 98.7%, specificity 95.5%). Furthermore, the logistic regression model with 6 haemoglobin peak features was also constructed to specifically identify β-thalassaemia (AUC 0.94, 95% CI 0.91–0.97, sensitivity 96.5%, specificity 87.8% in validation cohort 2). Conclusions For the first time, we constructed an inexpensive, accurate and high-throughput classification model based on MALDI-TOF mass spectrometry quantification of haemoglobin chains and demonstrated its great potential in rapid screening of thalassaemia in large populations.Key messages Thalassaemia is one of the most common inherited monogenic diseases worldwide with a heavy global health burden. We constructed a machine learning model based on MALDI-TOF mass spectrometry quantification of haemoglobin chains to screen for thalassaemia.