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Various erythropoietic abnormalities are highly prevalent among patients with pulmonary arterial hypertension (PAH) and associated with worse disease severity. Given the poorly understood yet important roles of dysregulated erythropoiesis and iron metabolism in PAH, we sought to further characterize the hematologic and iron profiles in PAH and their relationship to PAH severity. We recruited 67 patients with PAH and 13 healthy controls. Hemodynamics attained within 1 year of blood sample collection were available for 36 patients. Multiple hematologic, iron, and inflammatory parameters were evaluated for their association with hemodynamics. The subset with hemodynamic data consisted of 29 females (81%). The most common etiologies were idiopathic PAH (47%) and connective tissue disease-related PAH (33%). 19 (53%) had functional class 3 or 4 symptomatology, and 12 (33%) were on triple pulmonary vasodilator therapy. Immature reticulocyte fraction (IRF) had significant positive correlations with mean pulmonary artery (PA) pressure (mPAP) (0.59, p

Background and Aim: Anemia, a clinical condition characterized by reduced erythrocytes, is often observed in cats. Regeneration indicates that the bone marrow can respond appropriately to anemia. The absolute reticulocyte count is the reference for differentiating regenerative and non-regenerative anemia, while red blood cell (RBC) indices and morphology provide supplementary information. This study aimed to identify anemia types and establish the most reliable RBC indices and morphology methods in agreement with the reference method. Materials and Methods: One hundred forty-five cases of cat anemia were prospectively classified using two methods: RBC indices and RBC morphology, and subsequently compared with the absolute reticulocyte count. Results: Based on RBC indices assessment, 27 cases (19%) exhibited regenerative anemia. Based on RBC morphology, 29 (20%) cases were identified as having regenerative anemia. Using the reticulocyte absolute count as a reference method, 34 (23.4%) cases of regenerative anemia were identified. The findings indicated that RBC indices and RBC morphology did not align in evaluating medullary regeneration and that there is a good degree of agreement between RBC morphology assessment and the reticulocyte absolute count in identifying regenerative anemias. Conclusion: Blood smear analysis of RBC morphology was more dependable for classifying regenerative anemia than RBC indices. Further studies should be conducted with a larger number of animals and that allow the identification of the cause of anemia and the monitoring of the animal.

Background and Aim: Anemia, a clinical condition characterized by reduced erythrocytes, is often observed in cats. Regeneration indicates that the bone marrow can respond appropriately to anemia. The absolute reticulocyte count is the reference for differentiating regenerative and non-regenerative anemia, while red blood cell (RBC) indices and morphology provide supplementary information. This study aimed to identify anemia types and establish the most reliable RBC indices and morphology methods in agreement with the reference method. Materials and Methods: One hundred forty-five cases of cat anemia were prospectively classified using two methods: RBC indices and RBC morphology, and subsequently compared with the absolute reticulocyte count. Results: Based on RBC indices assessment, 27 cases (19%) exhibited regenerative anemia. Based on RBC morphology, 29 (20%) cases were identified as having regenerative anemia. Using the reticulocyte absolute count as a reference method, 34 (23.4%) cases of regenerative anemia were identified. The findings indicated that RBC indices and RBC morphology did not align in evaluating medullary regeneration and that there is a good degree of agreement between RBC morphology assessment and the reticulocyte absolute count in identifying regenerative anemias. Conclusion: Blood smear analysis of RBC morphology was more dependable for classifying regenerative anemia than RBC indices. Further studies should be conducted with a larger number of animals and that allow the identification of the cause of anemia and the monitoring of the animal. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anaemia is highly prevalent globally, especially among women of childbearing age. Aim: This retrospective study analysed haematological data of 289 women aged 18-45 years to evaluate the utility of routine laboratory parameters in predicting iron deficiency without advanced iron markers. Methods: Haemoglobin, haematocrit, red blood cell indices, platelet count, serum iron, total iron binding capacity (TIBC), transferrin saturation and serum ferritin were evaluated. Results: Compared to reference ranges, haemoglobin, haematocrit, serum ferritin and transferrin saturation were markedly reduced, clearly indicating iron deficiency anaemia. Although within normal limits, red blood cell count, mean corpuscular volume, mean corpuscular haemoglobin and serum iron approached lower thresholds, suggesting subtle deficiency. Other indices were unaffected. Declining haemoglobin, haematocrit and subtle red cell changes identified evolving iron restricted erythropoiesis prior to advanced iron depletion. Conclusion: These inexpensive, widely available blood count tests may facilitate screening and early treatment of iron deficiency in childbearing age women, especially important in resource-limited settings. Further research should evaluate these potential markers longitudinally through stages of sufficiency to deficiency. [ABSTRACT FROM AUTHOR]

Meiraf Daniel Meshesha,1 Ayantu Melke,2 Abraham Teka Ajema,2 Kaleb Mayisso3 1Department of Internal Medicine, Dilla University, Dilla, Ethiopia; 2Department of Epidemiology, Hawassa University, Hawassa, Ethiopia; 3Department of Public Health, Hawassa University, Hawassa, EthiopiaCorrespondence: Meiraf Daniel Meshesha, Tel +251 096 089 0307, Email meirafdanielm@gmail.comBackground: Achieving target glycemic control in people living with diabetes lessens most of the diabetes-related complications and hemoglobin A1C is the gold standard test for assessing the long-term glycemic control. However, the expensive cost, and its limited access are problematic for routine use in developing countries, demanding an urgent alternative solution. Hence, this study aimed to assess the potential of red blood cell indices in predicting glycemic control among people living with type 2 diabetes at Dilla University Hospital.Methods: A cross-sectional study was conducted among 207 participants with type 2 diabetes. Red blood cell indices were compared between the poor and good glycemic control groups using the t-test. Performance of red cell indices in discriminating poor glycemic control was assessed using receiver operating characteristic analysis.Results: The prevalence of poor glycemic control among the participants was 91.8%. Higher mean hemoglobin (p=0.002) and mean corpuscular hemoglobin (p=0.015) was found in the good glycemic control group. An inverse correlation was also observed between hemoglobin A1C and mean corpuscular hemoglobin (r=− 0.158; P=0.023). The area under the curve to discriminate poor glycemic control from good was statistically significant for hemoglobin, hematocrit, and mean corpuscular hemoglobin. However, hemoglobin had the highest discrimination ability at a cutoff ≤ 14.8 g/dL; area under the curve was 0.738 (P=0.001), sensitivity, specificity, and positive predictive value were 68.95%, 82.35%, and 97.77%, respectively.Conclusion: This study revealed that hemoglobin can potentially be used to assess glycemic control among people with type 2 diabetes but the interpretation needs to be cautious.Keywords: red blood cell indices, hemoglobin A1C, Ethiopia

This study aimed to explore the isomer-specific, sex-specific, and joint associations of PFAS and red blood cell indices. We used data of 1,238 adults from the Isomers of C8 Health Project in China. Associations of PFAS isomers and red blood cell indices were explored using multiple linear regression models, Bayesian Kernel Machine Regression models and subgroup analysis across sex. We found that serum concentration of linear (n-) and branched (Br-) isomers of perfluorooctane sulfonate (PFOS) and perfluorohexanesulfonic acid (PFHxS) were significantly associated with red blood cell indices in single-pollutant models, with stronger associations observed for n-PFHxS than Br-PFHxS, in women than in men. For instance, the estimated percentage change in hemoglobin concentration for n-PFHxS (3.65%; 95% CI: 2.95%, 4.34%) was larger than that for Br-PFHxS (0.96%; 95% CI: 0.52%, 1.40%). The estimated percentage change in red blood cell count for n-PFHxS in women (2.55%; 95% CI: 1.81%, 3.28%) was significantly higher than that in men (0.12%; 95% CI: −1.04%, 1.29%) (Pinter < 0.001). Similarly, sex-specific positive association of PFAS mixture and outcomes was observed. Therefore, the structure, susceptive population, and joint effect of PFAS isomers should be taken into consideration when evaluating the health risk of chemicals. [ABSTRACT FROM AUTHOR]

Red blood cells (RBCs) have emerged as biomarkers of the aging process as they undergo several changes in human aging and age-related diseases. The objectives of our study are to explore the effect of human aging on RBC indices, the strengths, therapeutic interventions, challenges, and future directions for using RBCs as a biomarker. Two online databases, PubMed and ScienceDirect, were used to search relevant studies using "RBCs as biomarkers of human aging," "red blood cells [MeSH Terms] AND biomarkers [MeSH Terms] AND human aging [MeSH Terms]," and "erythrocytes and human aging" as keywords. A total of 474 studies were identified, and after the removal of duplicates, excluding studies based on title, abstract, or full text, 74 studies and 48 additional studies found through cross-referencing were included in this systematic review. Based on the evidence, we concluded that RBC indices such as hemoglobin concentration, mean corpuscular volume, RBC distribution width, RBC membrane, oxidative stress, and metabolism change with human aging. Several studies have applied therapeutic interventions to RBCs, including dietary supplementation, phytochemicals, nanoparticles, and physical activity, to mitigate aging and related outcomes. Hence, the quality of life for older people and healthy aging can be improved by further investigating the RBC parameters, molecular mechanisms, and their implications for age-related health consequences. [ABSTRACT FROM AUTHOR]

Abstract Various erythropoietic abnormalities are highly prevalent among patients with pulmonary arterial hypertension (PAH) and associated with worse disease severity. Given the poorly understood yet important roles of dysregulated erythropoiesis and iron metabolism in PAH, we sought to further characterize the hematologic and iron profiles in PAH and their relationship to PAH severity. We recruited 67 patients with PAH and 13 healthy controls. Hemodynamics attained within 1 year of blood sample collection were available for 36 patients. Multiple hematologic, iron, and inflammatory parameters were evaluated for their association with hemodynamics. The subset with hemodynamic data consisted of 29 females (81%). The most common etiologies were idiopathic PAH (47%) and connective tissue disease‐related PAH (33%). 19 (53%) had functional class 3 or 4 symptomatology, and 12 (33%) were on triple pulmonary vasodilator therapy. Immature reticulocyte fraction (IRF) had significant positive correlations with mean pulmonary artery (PA) pressure (mPAP) (0.59, p

Background and Aims: The erythrocyte sedimentation rate (ESR) is an essential inflammatory marker in treating some patients, particularly children. The level of ESR can be affected by red blood cell (RBC) indices, and not considering this can complicate the interpretation of ESR and the treatment and follow‐up of patients. The study aimed to assess the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. Methods: A cross‐sectional study was conducted to measure the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. A total of 156 patients participated in the study. SPSS software was used for statistical analysis. Results: The mean age of participants was 27.26 ± 3.14 months. The results showed that there is a significant negative correlation between ESR and RBC, r = −0.282 (p < 0.001), and ESR and hematocrit (HCT), r = −0.215 (p = 0.007). Also, the results demonstrated that there is a significant positive correlation between ESR and mean corpuscular volume (MCV), r = 0.159 (p = 0.048), ESR and mean corpuscular hemoglobin (MCH), r = 0.214 (p = 0.007), and ESR and mean cell hemoglobin concentration (MCHC), r = 0.209 (p = 0.009). There was a negative correlation between ESR and hemoglobin (Hb), r = −0.98 (p = 0.225), but this correlation was insignificant. Conclusion: This study showed an association between ESR and RBC indices in hospitalized children with complaints of fever and cough. So, it is necessary that physicians and treatment staff pay attention to the RBC indices while interpreting and following up the results of ESR to complete the treatment process of patients. [ABSTRACT FROM AUTHOR]

Objective: Hematoma expansion is associated with unfavourable neurological outcomes in intracranial haemorrhage. We aimed to study association of red blood cell (RBC) indices, platelet indices, and their ratios with hematoma expansion, detected by serial computed tomography (CT). Methods: Hospital-based observational study of 88 patients with intracerebral hematoma referred for serial CT head with patients grouped as having progression/ no change/ resolution of hematoma. Baseline hematological indices and ratios were analysed. Results: 40 patients (45.5 %) had resolution, 20 patients (22.7 %) had no change and 28 patients (31.8 %) had progression of hematoma. RBC distribution width (RDW) (p value 0.001) and Plateletcrit (p-value 0.009) showed statistically significant difference among the groups. RBC distribution width (RDW) to PC ratio (RPR) showed statistically significant increase (p 0.0615 had greater chances of hematoma progression {OR 3.1 (95 % CI 1.22 to 7.91); p = 0.0174} Conclusion: Raised RPR was most significant parameter with higher RDW, lower plateletcrit values in patients with progression of intra-parenchymal hematoma. These readily available indices can aid in prompt prognostication of intracerebral haemorrhage cases.

Abstract Objective This study investigates the relationship between smoking and blood parameters in the Iranian Kurdish population. Method The current study was conducted based on the recruitment phase of the Ravansar Non-Communicable Disease (RaNCD) cohort study. Results Current smokers had higher levels of RBC count, HCT, HGB, MCV, MCH, MCHC, WBC count, and GR%, than in other groups significantly. Passive smokers had higher levels of PLT count and PCT statistically. The increasing exposure time of smoking positively affected WBC count, GR%, PLT count, PCT, and RDW in female passive smokers. In addition, heavy smokers, as well as participants with a higher duration time of smoking, had the same results for significantly lower levels of lymphocyte and monocyte and a higher level of RBC indices. Conclusion According to the present study, along with the current smokers, the intensity of smoking, as well as the duration time of the smoke, could have a positive correlation with blood parameters. Furthermore, passive smokers and specifically secondhand female smokers were more vulnerable to smoke.

Background: Studies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. Method: A total of 110 newborn babies with gestational age ≥34 weeks were considered and a ‘between-subjects’ design was used. The participants were divided into 3 groups- “Normal” (61 babies without maternal IDA), “Mild” (28 babies with mild maternal IDA) and “Moderate” (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k – 8 kHz) and a range of intensities (70–40 dB SPL in 10 dB steps). Results: The analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70–40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. Conclusion: The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Abstract Background and Aims The erythrocyte sedimentation rate (ESR) is an essential inflammatory marker in treating some patients, particularly children. The level of ESR can be affected by red blood cell (RBC) indices, and not considering this can complicate the interpretation of ESR and the treatment and follow‐up of patients. The study aimed to assess the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. Methods A cross‐sectional study was conducted to measure the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. A total of 156 patients participated in the study. SPSS software was used for statistical analysis. Results The mean age of participants was 27.26 ± 3.14 months. The results showed that there is a significant negative correlation between ESR and RBC, r = −0.282 (p

Background and Objectives Blood indices have variation in Covid-19 that could affect diagnosis. Blood index changes in Covid-19 inpatiens were evaluated. Materials and Methods In a descriptive/cross-sectional study, 167 Covid-19 inpatients in Besat Hospital in Hamedan were selected and in terms of changes on the first and seventh days of the blood indices were investigated. Data analysis was done with SPSS software version 26. In order to compare the blood indices on the first and seventh days of hospitalization, Wilcoxon and Monte Carlo tests were used. Results The average blood indices on the first and seventh day were 4.64 ± 0.59 and 4.39 ± 0.62 million in microliter (p< 0.001) for RBCs, 6.20 ± 3.84 and 7.55± 4.13 thousand in microliter (p< 0.001) for white blood cells, 179.54 ± 90.14 and 269.76 ± 109.03 thousand in microliter (p< 0.001) for platelets, 13.20 ± 1.71 and 12.27 ± 1.77 g/dL (p< 0.001) for hemoglobin, 40.45 ± 4.67 and 38.16 ± 5.02 % (p< 0.001) for hematocrit, 12.5 ± 0.55 and 13.1 ± 0.66 % (p< 0.001) for RDW, 87.18 ± 5.43 and 87.15 ± 5.62 femtoliters for MCV, 28.47 ± 2.16 and 28.18 ± 2.03 picograms (p= 0.002) for MCH and 32.56 ± 1.63 and 32.35 ± 1.64 g/dL for MCHC. Conclusions Blood indices in Covid-19 inpatients undergo changes from the time of admission to the seventh day. White blood cell, platelet and RDW were increased and red blood cell, hematocrit, hemoglobin, MCV, MCH and MCHC decreased compared to the first day of hospitalization. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the relationship between smoking and blood parameters in the Iranian Kurdish population. Method: The current study was conducted based on the recruitment phase of the Ravansar Non-Communicable Disease (RaNCD) cohort study. Results: Current smokers had higher levels of RBC count, HCT, HGB, MCV, MCH, MCHC, WBC count, and GR%, than in other groups significantly. Passive smokers had higher levels of PLT count and PCT statistically. The increasing exposure time of smoking positively affected WBC count, GR%, PLT count, PCT, and RDW in female passive smokers. In addition, heavy smokers, as well as participants with a higher duration time of smoking, had the same results for significantly lower levels of lymphocyte and monocyte and a higher level of RBC indices. Conclusion: According to the present study, along with the current smokers, the intensity of smoking, as well as the duration time of the smoke, could have a positive correlation with blood parameters. Furthermore, passive smokers and specifically secondhand female smokers were more vulnerable to smoke. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anemia (IDA) and beta-thalassemia trait (BTT) are the most common types of microcytic hypochromic anemias. The aim of this study was to evaluate the reliability of different RBC indices for discrimination between IDA and BTT in Sudanese patients. Methods and Results: This cross-sectional laboratory-based study was conducted among 200 patients (100 patients suffering from BTT and 100 from IDA) who attended the public health hospitals of Khartoum State (Sudan), from Jan 2021 to Feb 2022. The diagnosis of BTT was based on CBC and hemoglobin electrophoresis, and was confirmed by PCR. The diagnosis of IDA was based on complete blood count, reduced serum iron levels, and ferritin levels. Pregnant women, patients who had received a blood transfusion within three months of the study, and patients with thalassemia coexisting with IDA or other hemoglobinopathies were excluded from the study. A series of red blood cell indices were analyzed to differentiate IDA and BTT. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index (J) were calculated for each index. In BTT and IDA patients, mean values of Hb, hematocrit, and mean corpuscular volume were 10.9g/dL, 33.96%, 59.11fL, and 8.5g/dL, 26%, 68fL, respectively. All RBC indices were decreased in BTT and IDA. Mean RBC count was increased in BTT while showing normal values in IDA. In BTT patients, hemoglobin electrophoresis showed high HbA2 (6.4%) and HbF (1.95%) but a decreased HbA (78.2%). Conclusion: The best discrimination index according to J was Mentzer index (0.85), followed by Sidrah index (0.83), Ehsani index (0.81), RBC count (0.80), RDWI (0.79), Green and King index (0.76), MDHL (o.76), Srivastava index (o.76), and England and Fraser index (0.7). The lowest J was presented in Ricerca index (0.45), Shine and Lal index (0.01), and MCHD (0).

Objectives: To develop a machine learning (ML)-based framework using red blood cell (RBC) parameters for the prediction of the α+-thalassemia trait (α+-thal trait) and to compare the diagnostic performance with a conventional method using a single RBC parameter or a combination of RBC parameters. Methods: A retrospective study was conducted on possible couples at risk for fetus with hemoglobin H (Hb H disease). Subjects with molecularly confirmed normal status (not thalassemia), α+-thal trait, and two-allele α-thalassemia mutation were included. Clinical parameters (age and gender) and RBC parameters (Hb, Hct, MCV, MCH, MCHC, RDW, and RBC count) obtained from their antenatal thalassemia screen were retrieved and analyzed using a machine learning (ML)-based framework and a conventional method. The performance of α+-thal trait prediction was evaluated. Results: In total, 594 cases (female/male: 330/264, mean age: 29.7 ± 6.6 years) were included in the analysis. There were 229 normal controls, 160 cases with the α+-thalassemia trait, and 205 cases in the two-allele α-thalassemia mutation category, respectively. The ML-derived model improved the diagnostic performance, giving a sensitivity of 80% and specificity of 81%. The experimental results indicated that DeepThal achieved a better performance compared with other ML-based methods in terms of the independent test dataset, with an accuracy of 80.77%, sensitivity of 70.59%, and the Matthews correlation coefficient (MCC) of 0.608. Of all the red blood cell parameters, MCH < 28.95 pg as a single parameter had the highest performance in predicting the α+-thal trait with the AUC of 0.857 and 95% CI of 0.816–0.899. The combination model derived from the binary logistic regression analysis exhibited improved performance with the AUC of 0.868 and 95% CI of 0.830–0.906, giving a sensitivity of 80.1% and specificity of 75.1%. Conclusions: The performance of DeepThal in terms of the independent test dataset is sufficient to demonstrate that DeepThal is capable of accurately predicting the α+-thal trait. It is anticipated that DeepThal will be a useful tool for the scientific community in the large-scale prediction of the α+-thal trait. [ABSTRACT FROM AUTHOR]

Cognitive impairment has been associated with anemia and iron deficiency; however, brain electrophysiological studies correlating red blood cell (RBC) indices and iron status to cognition in adulthood are scarce. We aimed to assess neurocognitive function in young adults of the general population and its correlation with RBC indices and iron status. Neurocognitive function was investigated using scalp‐recorded event‐related potentials (ERPs) within the context of a task‐switching paradigm. ERPs and test performance were also compared across groups of "high"/"low" RBC and iron indices. Working memory was examined using the digit span test, in which mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), and ferritin were found to be significant predictors of test performance, with higher MCH/MCV/ferritin being associated with better test scores. In the switching task, MCH, MCV, and ferritin were found to be significant predictors of task performance, with higher MCH/MCV/ferritin levels associated with a lower percentage of errors. Electrophysiological results showed that MCH and MCV were significant predictors of ERPs amplitude, with lower MCH/MCV levels associated with greater amplitude, which may reflect compensatory processes. P1, N1, P2, and P3 were greater for the low MCH/MCV groups. This is the first evidence of association between levels of MCH/MCV and brain function while engaged in an executive function task; possibly reflecting brain iron availability. [ABSTRACT FROM AUTHOR]

Background: Research of late has brought to light a connect between Vitamin D and anemia. The level of 25hydroxyvitamin D (25(OH) D) is decreased in periodontitis subjects as against subjects without periodontitis and this reduced level could be related to more risk for anemia in periodontitis patients. Objective: This study aimed to evaluate the serum 25(OH) D levels and red blood cell indices in patients affected by generalized Stage III Grade B periodontitis and healthy controls and to assess the association between level of Vitamin D and red cell indices in periodontitis patients. Materials and Methods: The subjects were categorized into (i) case and (ii) control group of 30 each. Clinical parameters including oral hygiene index simplified, mean ratio of sites that bled on probing, gingival index, probing pocket depth, and the clinical attachment loss were assessed in both the groups. Subjects' blood samples (venous) were taken for the biochemical analysis. Results: In contradiction to healthy subjects, periodontitis subjects had significantly diminished 25(OH) D levels, hemoglobin (Hb), hematocrit, and mean corpuscular hemoglobin concentration (MCHC). 25(OH) D was moderately correlated with MCHC (r = 0.53) and it was statistically significant (P = 0.002). Conclusion: Periodontitis impacts Vitamin D status which further causes anemia. It suggests that effective management of periodontitis can help maintain sufficient Vitamin D status and may be vital in preventing anemia.

Background: Post-stroke cognitive impairment (PSCI) plagues 20-80% of stroke survivors worldwide. There is a lack of an easy and effective scoring tool to predict the risk of PSCI in intracerebral hemorrhage (ICH) patients. We aimed to develop a risk prediction model incorporating red blood cell (RBC) indices to identify ICH populations at risk of PSCI. Methods: Patients diagnosed with ICH at the stroke center were consecutively enrolled in the study as part of the development cohort from July 2017 to December 2018, and of the validation cohort from July 2019 to February 2020. Univariable and multivariable analyses were applied in the development cohort to screen the patients for PSCI risk factors. Then, a nomogram based on RBC indices and other risk factors was developed and validated to evaluate its performance in predicting PSCI occurrence. Results: A total of 123 patients were enrolled in the development cohort, of which 69 (56.1%) were identified as PSCI, while 38 (63.3%) of 60 patients in the validation cohort were identified as PSCI. According to the multivariate analysis, seven independent risk factors, including three RBC indices (hemoglobin, mean corpuscular volume, RBC distribution width), as well as age, education level, hematoma volume, and dominant-hemisphere hemorrhage were incorporated into the model. The nomogram incorporating RBC indices displayed good discrimination and calibration. The area under the receiver operating characteristic curve was 0.940 for the development cohort and 0.914 for the validation cohort. Decision curve analysis and clinical impact curve showed that the nomogram was clinically useful. Conclusion: RBC indices are independent and important predictors of PSCI. A nomogram incorporating RBC indices can be used as a reasonable and reliable graphic tool to help clinicians identify high cognition impairment-risk patients and adjust individualized therapy. [ABSTRACT FROM AUTHOR]

Red blood cell (RBC) indices, including mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH), have been widely used for primary screening for thalassaemia (thal) syndromes. Recently, a single nucleotide polymorphism (SNP) rs855791 of TMPRSS6, an iron regulation gene involved in the substitution of a nucleotide between thymine (T) and cytosine (C) in exon 17 resulted in an amino acid change, p.Val736Ala (V736A), has been described to associate with RBC indices. The objective was to study the effects of common SNP V736A on RBC indices in deletional α-thal variations. SNP rs855791 genotypes were identified from 433 Thai volunteers, including 32.6% males and 67.4% females with an average age of 23.0 ± 8.7 years. These populations included individuals (82.4%) who had normal globin genotype (αα/αα, ββ) and α-thal carriers, which were divided into two subgroups, including α+-thal (-α/αα) (14.1%) and αo-thal (--/αα) (3.5%). Among three SNP genotypes, the C allele gradually expressed higher MCV and MCH than those of the T allele in both α+- and αo-thal traits. Importantly, SNP rs855791 of TMPRSS6 responded to α-globin deletions for sustaining RBC sizes and haemoglobinisation in α-thal carriers. [ABSTRACT FROM AUTHOR]

Background: Research of late has brought to light a connect between Vitamin D and anemia. The level of 25hydroxyvitamin D (25(OH) D) is decreased in periodontitis subjects as against subjects without periodontitis and this reduced level could be related to more risk for anemia in periodontitis patients. Objective: This study aimed to evaluate the serum 25(OH) D levels and red blood cell indices in patients affected by generalized Stage III Grade B periodontitis and healthy controls and to assess the association between level of Vitamin D and red cell indices in periodontitis patients. Materials and Methods: The subjects were categorized into (i) case and (ii) control group of 30 each. Clinical parameters including oral hygiene index simplified, mean ratio of sites that bled on probing, gingival index, probing pocket depth, and the clinical attachment loss were assessed in both the groups. Subjects' blood samples (venous) were taken for the biochemical analysis. Results: In contradiction to healthy subjects, periodontitis subjects had significantly diminished 25(OH) D levels, hemoglobin (Hb), hematocrit, and mean corpuscular hemoglobin concentration (MCHC). 25(OH) D was moderately correlated with MCHC (r = 0.53) and it was statistically significant (P = 0.002). Conclusion: Periodontitis impacts Vitamin D status which further causes anemia. It suggests that effective management of periodontitis can help maintain sufficient Vitamin D status and may be vital in preventing anemia. [ABSTRACT FROM AUTHOR]

Objective: To find association of red blood cell indices and erythrocyte sedimentation rate (ESR) in COPD patients. Study Design: Retrospective case control study. Place and Duration of Study: University of Health Sciences Lahore, from Oct to Dec 2019. Methodology: This study was conducted at University of Health Sciences Lahore after approval from Institutional Review Board of University of Health Sciences Lahore. The Data was assessed by IBM-SPSS version 24. Significance of the associations was assessed by Fisher’s Exact test and independent sample t-test. Results: The continuous variables of our data were having normal distribution hence their mean ± standard deviations were calculated. Mean age of the cases with COPD was 56.22 ± 11.34. Mostly were males (91%). The prevalence of the cases and the controls was also calculated by comparing them with different demographic variables. It was found to be highly statistically significant when compared with age (p=0.04). Age group of 51-65 was also more affected with COPD then the other age groups. Patients with lower socio-economic group were found to be more affected by COPD then those from other socio economic groups. When association of COPD was seen with different red blood cell indices then it was striking to find out that the mean corpuscular hemoglobin concentration (MCHC) was significantly associated (p=0.03). Erythrocyte sedimentation rate was also found to be strongly associated with COPD cases (p=0.001). Conclusion: Hence it is concluded that the red blood cell indices and ESR have a strong association with COPD.

BackgroundAnemia has been linked to adverse human immunodeficiency virus (HIV) outcomes, including dementia, in the era before highly active antiretroviral therapy (HAART). Milder forms of HIV-associated neurocognitive disorder (HAND) remain common in HIV-infected persons, despite HAART, but whether anemia predicts HAND in the HAART era is unknown.MethodsWe evaluated time-dependent associations of anemia and cross-sectional associations of red blood cell indices with neurocognitive impairment in a multicenter, HAART-era HIV cohort study (N = 1261), adjusting for potential confounders, including age, nadir CD4(+) T-cell count, zidovudine use, and comorbid conditions. Subjects underwent comprehensive neuropsychiatric and neuromedical assessments.ResultsHAND, defined according to standardized criteria, occurred in 595 subjects (47%) at entry. Mean corpuscular volume and mean corpuscular hemoglobin were positively associated with the global deficit score, a continuous measure of neurocognitive impairment (both P < .01), as well as with all HAND, milder forms of HAND, and HIV-associated dementia in multivariable analyses (all P < .05). Anemia independently predicted development of HAND during a median follow-up of 72 months (adjusted hazard ratio, 1.55; P < .01).ConclusionsAnemia and red blood cell indices predict HAND in the HAART era and may contribute to risk assessment. Future studies should address whether treating anemia may help to prevent HAND or improve cognitive function in HIV-infected persons.

Introduction: Anaemia in subjects with T2DM is not an infrequent finding. HbA1c, a biomarker of choice for glycaemic control is altered by anaemia and abnormal red blood cell (RBC) indices. Hence, this study's main objective is to determine the prevalence of anaemia and abnormal RBC indices among type 2 diabetes mellitus (T2DM) subjects who had HbA1c measurement performed in Hospital Kuala Lumpur (HKL). Method: A retrospective study of 305 subjects with concurrent HbA1c and FBC performed in Pathology Laboratory, HKL from January 2017 to December 2017. The demographic and laboratory parameters of the subjects (total Hb, MCV, MCH, MCHC, HbA1c, iron, ferritin, folate, B12) were attained from the laboratory information system (LIS). Results: A total of 113 (37%) subjects had anaemia, whilst 131 (43%) had abnormal RBC indices. The anaemia was mostly mild (n=70, 61.9%) and normocytic normochromic (n=63, 55.8%). The median HbA1c for the anaemia group was lower (HbA1c=7.52%) compared to the non-anaemia group (HbA1c=8.3%) (p=0.03). The median HbA1c was significantly higher in those with microcytic hypochromic anaemia (HbA1c=7.9%) compared to normocytic normochromic anaemia (HbA1c=7.2%) (p=0.025). Conclusion: The prevalence of anaemia among T2DM subjects was 37% with the majority being mild and normocytic normochromic. HbA1c measurement is affected by anaemia and hence, whenever possible, HbA1c results should be reviewed together with the FBC results. [ABSTRACT FROM AUTHOR]

Background and Aim: Anemia, a clinical condition characterized by reduced erythrocytes, is often observed in cats. Regeneration indicates that the bone marrow can respond appropriately to anemia. The absolute reticulocyte count is the reference for differentiating regenerative and non-regenerative anemia, while red blood cell (RBC) indices and morphology provide supplementary information. This study aimed to identify anemia types and establish the most reliable RBC indices and morphology methods in agreement with the reference method., Materials and Methods: One hundred forty-five cases of cat anemia were prospectively classified using two methods: RBC indices and RBC morphology, and subsequently compared with the absolute reticulocyte count., Results: Based on RBC indices assessment, 27 cases (19%) exhibited regenerative anemia. Based on RBC morphology, 29 (20%) cases were identified as having regenerative anemia. Using the reticulocyte absolute count as a reference method, 34 (23.4%) cases of regenerative anemia were identified. The findings indicated that RBC indices and RBC morphology did not align in evaluating medullary regeneration and that there is a good degree of agreement between RBC morphology assessment and the reticulocyte absolute count in identifying regenerative anemias., Conclusion: Blood smear analysis of RBC morphology was more dependable for classifying regenerative anemia than RBC indices. Further studies should be conducted with a larger number of animals and that allow the identification of the cause of anemia and the monitoring of the animal., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Fernandes, et al.)

Objective: To find association of red blood cell indices and erythrocyte sedimentation rate (ESR) in COPD patients. Study Design: Retrospective case control study. Place and Duration of Study: University of Health Sciences Lahore, from Oct to Dec 2019. Methodology: This study was conducted at University of Health Sciences Lahore after approval from Institutional Review Board of University of Health Sciences Lahore. The Data was assessed by IBM-SPSS version 24. Significance of the associations was assessed by Fisher’s Exact test and independent sample t-test. Results: The continuous variables of our data were having normal distribution hence their mean ± standard deviations were calculated. Mean age of the cases with COPD was 56.22 ± 11.34. Mostly were males (91%). The prevalence of the cases and the controls was also calculated by comparing them with different demographic variables. It was found to be highly statistically significant when compared with age (p=0.04). Age group of 51-65 was also more affected with COPD then the other age groups. Patients with lower socio-economic group were found to be more affected by COPD then those from other socio economic groups. When association of COPD was seen with different red blood cell indices then it was striking to find out that the mean corpuscular hemoglobin concentration (MCHC) was significantly associated (p=0.03). Erythrocyte sedimentation rate was also found to be strongly associated with COPD cases (p=0.001). Conclusion: Hence it is concluded that the red blood cell indices and ESR have a strong association with COPD. [ABSTRACT FROM AUTHOR]

In this latest article in the AJN series Back to Basics--developed to improve nurses' understanding and application of common laboratory diagnostic tests--the author delineates the meaning and function of complete blood count components, highlighting the important pathophysiological evidence they provide and using composite patient scenarios to assist nurses in recognizing findings that can inform their plan of care and produce the best patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Hemoglobin & red blood cell indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width) among adolescent. Study Design: Cross-Sectional study (Descriptive). Setting: Department of Physiology, Baqai Medical University (BMU) Karachi. Period: 6 months from February to August 2017. Material & Methods: A total of 500 students of MBBS, BDS, DPT with having age ranges from 18-25 years were enrolled in this study. The anthropometric measurement [height (m2) and weight (kg)] was recorded for calculation of the Body Mass Index and Complete blood count i-e Hemoglobin (Hb%), Mean Corpuscular Volume (MCV), Mean corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC), Red cell distribution width (RDW) was done and calculated. Data analysis was done on Microsoft excel & SPSS version 22.0 was used. Results: It was seen that the comparison of Hb%, MCV & RDW had no significant (p>0.001) association of study participants to different categories of Body Mass Index. Mean corpuscular hemoglobin (MCH) (X²=28.278, p<0.001) and Mean corpuscular hemoglobin concentration (MCHC) (X²=15.659, p=0.016) were statistically significantly association with different categories of Body Mass Index. Conclusion: Mean corpuscular hemoglobin and Mean corpuscular hemoglobin concentration had statistically significant (p<0.001) association with body mass index (BMI). [ABSTRACT FROM AUTHOR]

BACKGROUND: Iron deficiency anaemia (IDA) is a common finding among patients with chronic kidney disease (CKD) and a major contributor to the high morbidity, mortality and poor quality of life associated with the disease. Assessment of iron deficiency anaemia has become routine in the evaluation of patients with CKD and iron studies such as serum ferritin, total iron binding capacity and transferrin saturation are recommended as standard diagnostic work up. However, in Nigeria and other low and middle income countries (LMICs) where most patients pay out of pocket, only few patients could afford iron studies, in addition to other cost of care. It is therefore imperative to find and establish the utility of other relatively affordable markers of iron deficiency among patients in LMICs. In studies done within the general population, the percentage of hypochromic red blood cells (PHRC), RBC indices and reticulocyte haemoglobin concentration (CHr) have been shown to predict iron deficiency. However, the usefulness of these in CKD patients had not been established. Thus, we determined the utility of PHRC and RBC indices among patients with CKD. METHODS: this is a cross sectional survey of 157 participants with CKD and 157 apparently healthy controls. The patients with CKD were individuals receiving care at the renal unit of the University College Hospital, Ibadan. Clinical data were collected using standard care report forms and information obtained were demographic details, aetiologies of CKD, dialysis status, symptoms of iron deficiency anaemia, modalities of anaemia treatments and other medications. Blood samples were collected for iron studies, full blood count, red blood cell (RBC) indices, peripheral blood film for PHRC, plasma highly sensitive C- reactive protein, serum electrolytes, urea and creatinine. Data was analyzed using SPSS version 23. RESULTs: a total of 314 participants were enrolled in the study, half of them were patients with CKD while the remaining half were controls without CKD. The mean age for cases and controls were [a href=´#ref45.5±14.4 vs 46.1±15.5 years respectively´45.5±14.4 vs 46.1±15.5 years respectively/aa href=´#ref p = 0.72´ p = 0.72/a ] =a href=´#refwhile females were 57% vs 60.1%´while females were 57% vs 60.1% /a, a href=´#ref p = 0.06´ p 0.06/a]. The prevalence of IDA using iron studies [a href=´#ref67 (42.6%) vs 33 (21.0%)´67 (42.6%) vs 33 (21.0%)/a,a href=´#ref p = 0.01 p =0.01/a], RBC indices [a href=´#ref46 (29.3%) vs 25 (15.9%)´46 (29.3%) vs 25 (15.9%) /a,a href=´#ref p = 0.002´= p 0.002/a], and PHRC [a href=´#ref48 (30.5%) vs 32 (20.4%)´48 (30.5%) vs 32 (20.4%)/a, a href=´#ref p = 0.038´= p =0.038=/a]. The sensitivity and specificity of RBC indices and PHRC as surrogate markers of iron deficiency anaemia were [a href=´#ref73.8% ; 92.0%´73.8% ; 92.0% /a ] and [a href=´#ref80.0% ; 92.3%´=80.0% ; 92.3%/a,a href=´#ref´/a] respectively. CONCLUSION: this study confirmed that the 3 methods of diagnosis of iron deficiency anaemia vis-a-vis iron studies (Serum ferritin and TSAT), RBC indices and percentage hypochromic RBC, all demonstrated high prevalence of iron deficiency anaemia among patients with CKD. While RBC indices and percentage hypochromic RBC are reliable and highly specific surrogate markers of iron deficiency anaemia among individuals with CKD.

Introduction: Alpha thalassaemia is one of the haemoglobin disorders in which the carriers of alpha thalassaemia may have normal haemoglobin level and are eligible to donate blood which may bring complications. This study is to investigate the interaction of haematological parameter with a-globin genotypes among eligible blood donors. Materials & Methods: A cohort study with 270 eligible blood donors were analysed for red cell indices. Alpha-globin (a-globin) genotyping was performed for seven deletions, six point mutations and two triplications. Statistical analyses were performed to compare the α-globin genotypes with haematological data. Results: High prevalence of α-thalassaemia carriers (7.7%, 21/270) was found among blood donors. All of them did not show anaemic pictures with a normal Hb level (>12 gm/dl). Five genotypes were identified consisting of 249 αα/αα (92.2%), nine -α3.7/αα (3.3%), nine--SEA/αα (3.3%), two -α4.2/αα (0.7%) and one ααCS/αα (0.4%). Different α-globin genotypes showed a significant difference in RBC, MCV, MCH, MCHC, RDW, and Hct/Hb ratio (p<0.05) due to the different extent of α-globin chain reduction. Conclusion: Our study concluded that by using Hb level alone is not sufficient to screen for the eligibility of blood donors. Full blood count (FBC) screening with borderline MCV and MCH levels might be able to rule out silent α-thalassemia carriers. FBC and molecular characterisation should be incorporated together to properly rule out α-thalassaemia carriers. [ABSTRACT FROM AUTHOR]

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Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia. [ABSTRACT FROM AUTHOR]

Abstract Objective Anaemia is a serious problem in pregnancy in malaria-endemic countries. This study investigated red cell morphologies and possible causes of anaemia among pregnant women at first clinic visit. Venous blood samples from consented women were used to determine haemoglobin (Hb) levels, mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) using an automated haematology analyzer. Malaria parasitaemia was diagnosed by microscopy. Definitions were as follows: anaemia (Hb 101 fl), hypochromasia (MCH

Background: Premature Ovarian Insufficiency (POI) is associated with infertility. Little is known about the potential circulating biomarkers that could be used to predict POI. We have investigated the possible association between white and red blood cells, platelet indices, and eight established single nucleotide polymorphisms (SNPs) associated with POI risk., Methods: 117 women with premature menopause (PM) and 183 healthy women without a history of menopause before age 40 were recruited for this study. The tetra-primer amplification refractory mutation system-polymerase chain reaction (Tetra ARMS PCR) and allele-specific oligonucleotides- polymerase chain reaction (ASO-PCR) were carried out for genotyping for eight SNPs reported to be associated with POI. Decision tree analysis was applied to test the diagnostic value of hematological parameters to identify the risk of POI., Results: Women with POI had lower neutrophil (NEUT) and white blood cell (WBC), whereas red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and mean cell hemoglobin (MCH) were higher. Platelet (PLT) count was also lower in affected women. Our data also indicated that HGB and HCT count were significantly associated with rs16991615 and rs244715. Mean Platelet volume (MPV) and platelet distribution width (PDW) were associated with rs244715, rs1046089, rs4806660, and rs2303369. The rs16991615 was also associated with RBC count, and rs451417 was associated with NEUTs. The decision tree (DT) model reveals that women with the NEUT count at a cut-off value of less than 2.8 and HCT equal to or more than 38.7% could be identified as high-risk cases for POI. Overall, we found the DT approach had a sensitivity = 85%, specificity = 72%, and accuracy = 74%., Conclusion: The genetic variants involved in POI are associated with changes in reproductive hormone levels and with changes in hematological indices., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Most guidelines all over the world recommended metformin as the first-line treatment for in type 2 diabetic patients. Therefore, the present study was suggested to assess the outcome of metformin administration and glycemic status on alterations in red blood cell (RBCs) indices as well as the oxidative stress in type 2 diabetic patients. Methods: Between December 2016 and October of 2017, a total of 158 eligible individuals were classified as 50 healthy subjects and 108 diabetic patients who were subdivided into six groups according to the type of anti-diabetic treatments. Results: Overall, the results elucidated that hemoglobin concentration was markedly diminished, while red cell distribution width (RDW) value was significantly (P < 0.001) elevated in all diabetic groups as compared to control. Moreover, in all diabetic groups, malondialdehyde (MDA) concentration was elevated noticeably (P < 0.001), while reduced glutathione (GSH) revealed a lower concentration (P < 0.001) than that of control. Conclusion: The present study exhibited the amelioration effect of metformin administration on oxidative stress and glycemic status which reflected on some RBCs indices. However, hemoglobin concentration showed a noticeable diminution in all metformin-treated groups in spite of the improvement in glycemic and oxidative stress status which indicated that the metformin-induced anemia is independently from diabetic complications. [ABSTRACT FROM AUTHOR]

Highlights • Abnormal RBC indices increase risk of ATE and VTE. • Low MCV, MCH and high RDW levels were risk factors of AIS in this population. • Abnormal RBC indices may contribute to the disturbance of endothelial system. Abstract A high red cell distribution width (RDW) and low hemoglobin level increase the risk of arterial ischemic stroke (AIS), mostly in adults. The mechanisms related to AIS remain unknown. A total of 233 subjects (90 patients and 143 healthy controls [HC]) were enrolled. The mean(SD) age in patients and HC was 9.5(3.8) and 11.4(1.8) years, respectively. We found increased odds ratios (ORs) for large vessel and small vessel subtypes in patients without underlying diseases with a mean corpuscular volume (MCV) <80 fL (OR: 5.4, 95%CI 1.8–16.3 and 2.8, 95%CI 1.2–7.2), mean corpuscular hemoglobin levels <27 pg (OR: 2.9, 95%CI 1.0–6.7 and 2.6, 95%CI 1.0–6.7), and RDW >15% (OR: 5.5, 95%CI 1.3–24.5 and 2.7, 95%CI 1.0–7.3). RBC indices showed significant correlations with TM levels. Therefore, low MCV and MCH levels, and a high RDW were risk factors for AIS and associated with TM levels in this population. [ABSTRACT FROM AUTHOR]

Introduction: Screening for alpha (α) thalassaemia trait (TT) is challenging especially in the presence of iron deficiency (ID). Red blood cell size factor (RSf) is a parameter introduced by Beckman Coulter capable of detecting acute and chronic changes to cellular haemoglobin status and iron supply. The research aimed to investigate the clinical usefulness of RSf as screening parameter for α TT and the effect of concomitant ID to RSf mean values (m.v) among respondents with α TT. Methods: A cross-sectional retrospective laboratory analysis involved 55 respondents' data selected from January 2014 to December 2015 in Pathology Department, Hospital Tuanku Ja'afar Seremban, Negeri Sembilan. The significant difference at p <0.05 in the RSf m.v. among respondents with α0 TT, α+ TT, and ID groups and the effect concomitant ID to RSf m.v. were determined using statistical test, one-way analysis of variance (ANOVA). Results: Significant differences were detected in RSf m.v. i) between α0 TT, α+ TT and ID, F (2, 52) = 18.99, p=0.001. ii) between α TT without ID, α TT with ID and ID cohorts for both a) α0 TT [F (2, 33) = 23.77, p=0.001) and b) α+ TT [F (2, 28) = 5.37, p=0.011]. iii) between α TT and ID group regardless of the presence of ID for both a) α0 TT and b) α+ TT. Conclusion: RSf is a potential screening parameter in evaluating patients with hypochromic microcytosis in identifying possible cases of alpha TT regardless of iron status. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol has many serious effects on cells and tissues and consequently causes major health diseases. Erythrocyte functions are depending on many factors which are shown increased in red blood cells (RBCs) dysfunction is related to alcoholism. Objective: The aim of the present study is to evaluate the effects of alcohol on erythrocyte indices. Materials and Methods: The experiment includes 20 rats divided into four groups under the same environment and same weight which are continuously fed with different alcohol concentrations (15%, 20%, and 25%), and one control that feeds with water only for 21 days. Results: The findings are that RBC's indices increased significantly (P* < 0.05) with the alcohol concentrations such as mean corpuscular volume, mean corpuscular hemoglobin (Hb) (MCH), MCH concentration, Hb, and hematocrit except the RBC counts. Conclusion: In conclusion, alcoholism can induce different effects on RBC indices particularly size and mass of Hb and its concentration in RBCs which can cause anemia and may return normal after alcohol abstinence. [ABSTRACT FROM AUTHOR]

Background: β-thalassemia trait (β-TT) is an important differential diagnosis of iron deficiency anemia (IDA). It is important to distinguish between the above conditions to avoid unnecessary iron therapy. IDA and β-TT are the two most common causes of microcytic hypochromic anemia. Red blood cells (RBCs) indices are a simple, easy, and cost-effective method to get a primary and valuable information regarding the diagnosis of IDA and β-TT. Objectives: This study was focused on the comparison of RBC indices behavior: hemoglobin (Hb), hematocrit (Hct), RBC count, mean cell volume (MCV), mean cell hemoglobin (MCH), MCH concentration (MCHC), and red cell distribution width (RDW) in IDA and β-TT. Patients and Methods: Fifty subjects with IDA (12 males and 38 females, age range: 18-65 years) and fifty subjects with β-TT (twenty male and thirty females with age range: 17-66 years) were chosen. Both groups were investigated for RBC indices by automated hematology analyzer. Results: RBC count, Hb, and Hct were significantly lower with (P < 0.001) in IDA subjects than in β-TT subjects. MCH and MCHC were significantly lower with (P = 0.01 and 0.001, respectively) in IDA subjects than in β-TT subjects. RDW was significantly higher with (P < 0.001) in IDA subjects than in β-TT subjects. There is no significant difference with (P = 0.2) regarding MCV between IDA subjects and β-TT subjects. Conclusion: The study showed that RBC count, Hb, Hct, MCH, and MCHC were significantly lower in IDA subjects than in β-TT subjects, whereas RDW was significantly higher in IDA subjects than in β-TT subjects. There was no significant difference regarding MCV between IDA subjects and β-TT subjects.

Background: α-thalassemia is one of the common prevente hematological disorders in the Iranian population; knowing its most common mutations can improve the prenatal diagnosis of the disease. To date of this study, no comprehensive data were available on the prevalence of the disease in Chahar Mahal va Bakhtiari Province, Iran. For the first time, this study investigated the spectrum of α-thalassemia mutations and their correlation with red blood cell (RBC) indices in this region. Methods: 128 carriers who resided in the Chahar Mahal va Bakhtiari Province were evaluated for α-thalassemia mutations using gap polymerase chain reaction (GAP-PCR), amplification refractory mutation system-polymerase chain reaction (ARMS-PCR), multiplex-ligation-probe-dependent polymerase assay (MLPA) and sequencing methods. The RBC indices were measured. The data were analyzed using chi-square and t tests. Findings: The presence of 6 deletions including α3.7 (83.2%), α20.5 (5.9%), αMED (5%), α4.2 (2.5%), del Hbz-Hba1 (0.8%) and HS-40 (0.8%) as well as the point mutation of Hb-CS (1.7%) on the α-globin gene were approved. Analysis of correlation between different mean corpuscular volume (MCV) measures and α-thalassemia indicated that 78>MCV>75 was correlated with α3.7, α4.2 and Hb-CS mutation and MCV of less than 75 was correlated with α3.7, α20.5, αMED, and del Hbz-Hba1. Among the analyzed mutations, the only mutation with 78 < MCV < 80 or low MCV (< 80) and normal (> 27) mean corpuscular hemoglobin (MCH) was α3.7. Interestingly, mutations with low (< 27) and normal (> 80) MCV were α3.7 and Hb-CS, respectively. Conclusion: Together, the data suggested the presence of a positive relationship between α-thalassemia mutations and RBC indices, which could facilitate rapid and efficient screening for these common mutations in the population of Chahar Mahal va Bakhtiari Province.

Objective: Anaemia is a serious problem in pregnancy in malaria-endemic countries. This study investigated red cell morphologies and possible causes of anaemia among pregnant women at first clinic visit. Venous blood samples from consented women were used to determine haemoglobin (Hb) levels, mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) using an automated haematology analyzer. Malaria parasitaemia was diagnosed by microscopy. Definitions were as follows: anaemia (Hb < 11.0 g/dl), microcytosis (MCV < 78 fl), macrocytosis (MCV > 101 fl), hypochromasia (MCH < 27 pg), microcytic hypochromia or normocytic hypochromia with anaemia [iron deficiency anaemia (IDA)], normocytic normochromia with anaemia in the absence of malaria parasitaemia (physiological anaemia of pregnancy). Results: Of the 279 pregnant women enrolled, 57% had anaemia. Malaria parasitaemia was associated with 23.3% of anaemic cases while 76.7% were non-malaria related. The distribution of red cell alterations was as follows: hypochromasia (32.6%), microcytosis (14.7%) and macrocytosis (1.1%). The co-occurrence of malaria parasitaemia, iron defi- ciency and anaemia was seen in 23.3% of the women, iron deficiency anaemia only occurred in 35.9% while physiological anaemia of pregnancy was 40.9%. Iron deficiency and physiological anaemia of pregnancy contribute to a greater proportion of anaemia in the study area. [ABSTRACT FROM AUTHOR]