Abstract: The impact of metabolic syndrome (MetS) on cognition and functions of the brain is being investigated. Iron deficiency and deficiencies of B9 (folate) as well as B12 (cobalamin) vitamins are best-known nutritional anemias. They are associated with cognitive disorders and learning difficulties. The antidepressant effects of vitamin D are known and the deficiency state affects mental functions negatively. The aim of this study is to investigate possible correlations of MetS with serum brain-derived neurotrophic factor (BDNF), iron, folate, cobalamin and vitamin D in pediatric patients. 30 children, whose age- and sex-dependent body mass index (BMI) percentiles vary between 85 and 15, 60 morbid obese children with above 99th percentiles constituted the study population. Anthropometric measurements were taken. BMI values were calculated. Age- and sex-dependent BMI percentile values were obtained using the appropriate tables prepared by the World Health Organization (WHO). Obesity classification was performed according to WHO criteria. Those with MetS were evaluated according to MetS criteria. Serum BDNF was determined by enzyme-linked immunosorbent assay. Serum folate was analyzed by an immunoassay analyzer. Serum cobalamin concentrations were measured using electrochemiluminescence immunoassay. Vitamin D status was determined by the measurement of 25-hydroxycholecalciferol [25-hydroxy vitamin D3, 25(OH)D] using high performance liquid chromatography. Statistical evaluations were performed using SPSS for Windows, version 16. The p values less than 0.05 were accepted as statistically significant. Although statistically insignificant, lower folate and cobalamin values were found in MO children compared to those observed for children with normal BMI. For iron and BDNF values, no alterations were detected among the groups. Significantly decreased vitamin D concentrations were noted in MO children with MetS in comparison with those in children with normal BMI (p ≤ 0.05). The positive correlation observed between iron and BDNF in normal-BMI group was not found in two MO groups. In THE MetS group, the partial correlation among iron, BDNF, folate, cobalamin, vitamin D controlling for waist circumference and BMI was r = -0.501; p ≤ 0.05. None was calculated in MO and normal BMI groups. In conclusion, vitamin D should also be considered during the assessment of pediatric MetS. Waist circumference and BMI should collectively be evaluated during the evaluation of MetS in children. Within this context, BDNF appears to be a key biochemical parameter during the examination of obesity degree in terms of mental functions, cognition and learning capacity. The association observed between iron and BDNF in children with normal BMI was not detected in MO groups possibly due to development of inflammation and other obesity-related pathologies. It was suggested that this finding may contribute to mental function impairments commonly observed among obese children.
Abstract: In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.
Abstract: In this research article, a comprehensive analysis is performed to compare the diagnostic performance of soluble transferrin receptor (sTfR) and sTfR/log ferritin index tests in the differential diagnosis of iron deficiency anemia (IDA) and anemia of chronic disease (ACD). The analysis is performed for both sTfR and sTfR/log ferritin index using a set of 11 studies. The overall odds ratios for sTfR and sTfR/log ferritin index were 36.79 and 119.32 respectively, using 95% confidence interval. The relative sensitivity, specificity. positive likelihood ratio (LR) and negative LR values for sTfR in relation to sTfR/log ferritin index were 81% vs 85%, 84% vs 93%, 6.31 vs 13.95 and 0.18 vs 0.14 respectively. The summary receiver operating characteristic (SROC) curves are also plotted for both sTfR and sTfR/log ferritin index. The area under SROC curves for sTfR and sTfR/log ferritin index was found to be 0.9296 and 0.9825 respectively. Although both tests are useful, the sTfR/log ferritin index seems to be more effective when compared with sTfR.
Abstract: The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.
Abstract: Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).
Abstract: Hemoglobin (HB) indicates anemia level and by
extension may reflect the nutritional level and perhaps the immunity
of an individual. Some antiretroviral drugs like Zidovudine are
known to cause anemia in people living with HIV/AIDS (PLWHA).
A cross sectional study using demographic data and blood specimen
from 218 female commercial sex workers attending antiretroviral
therapy (ART) clinics was conducted between December, 2009 and
July, 2011 to assess the effect of zidovudine on hematologic, and
RNA viral load of female sex workers receiving antiretroviral
treatment in north western Nigeria. Anemia is a common and serious
complication of both HIV infection and its treatment. In the setting of
HIV infection, anemia has been associated with decreased quality of
life, functional status, and survival. Antiretroviral therapy,
particularly the highly active antiretroviral therapy (HAART), has
been associated with a decrease in the incidence and severity of
anemia in HIV-infected patients who have received a HAART
regimen for at least 1 year. In this study, result has shown that of the
218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were
observed to have the highest viral load count of 300,000 –
350,000copies/ml. It was also observed that most patients (190) with
HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000
copies /ml. An inverse relationship therefore exists i.e. the lower the
hemoglobin level, the higher the viral load count even though the test
statistics did not show any significance between the two (P = 0.206).
This shows that multivariate logistic regression analysis
demonstrated that anemia was associated with a CD4 + cell count
below 50/μL, female sex workers with a viral load above 100,000
copies/mL, who use zidovudine.
Severe anemia was less prevalent in this study population than in
historical comparators; however, mild to moderate anemia rates
remain high. The study therefore recommends that hematological and
virologic parameters be monitored closely in patients receiving first
line ART regimen.
Abstract: Iron is an essential nutrient with limited
bioavailability. Nutritional anemia caused mainly by iron deficiency
is the most recognized nutritional problem in both countries as well
as affluent societies. Rice (Oryza sativa L.) has become the most
important cereal crop for the improvement of human health due to the
starch, protein, oil, and the majority of micronutrients, particularly in
Asian countries. In this study, the iron availability and profile lipid
were evaluated for the extracts from Cibeusi varieties (black rices) of
ancient rice brans.
Results: The quality of K, B, R, E diets groups shows the same
effect on the growth of rats. Hematocrit and MCHC levels of rats fed
K, B, R and E diets were not significantly (P
Abstract: Red blood cells (RBC) are the most common types of
blood cells and are the most intensively studied in cell biology. The
lack of RBCs is a condition in which the amount of hemoglobin level
is lower than normal and is referred to as “anemia”. Abnormalities in
RBCs will affect the exchange of oxygen. This paper presents a
comparative study for various techniques for classifying the RBCs as
normal or abnormal (anemic) using WEKA. WEKA is an open
source consists of different machine learning algorithms for data
mining applications. The algorithms tested are Radial Basis Function
neural network, Support vector machine, and K-Nearest Neighbors
algorithm. Two sets of combined features were utilized for
classification of blood cells images. The first set, exclusively consist
of geometrical features, was used to identify whether the tested blood
cell has a spherical shape or non-spherical cells. While the second
set, consist mainly of textural features was used to recognize the
types of the spherical cells. We have provided an evaluation based on
applying these classification methods to our RBCs image dataset
which were obtained from Serdang Hospital - Malaysia, and
measuring the accuracy of test results. The best achieved
classification rates are 97%, 98%, and 79% for Support vector
machines, Radial Basis Function neural network, and K-Nearest
Neighbors algorithm respectively.
Abstract: Fever, bloody diarrhea and high mortality rate were the main clinical finding in a group of fattening calves. Analysis of corn silage revealed presence of aflatoxins at level of 370 ppb. This level of aflatoxins in the feed of cattle is somewhat low to be the main cause of reported signs. Leukocytopenia, anemia, decreased lymphocytic activity and lowered phagocytic index are the main hematological and immunological alterations in diseased calves. Bacteriological investigation revealed isolation of pathogenic Salmonella typhimurium from the rectal swabs of diseased calves. Our results suggested that, long duration of exposure to aflatoxins even at small concentrations may considered as predisposing factor for the incidence of natural infectious outbreaks as salmonellosis due to its immunosuppressive effect. We can conclude that the veterinarians and owners must be given an attention to the relation between aflatoxicosis and salmonellosis under field condition. We are recommended that the treatment program during similar outbreaks must be including anti-aflatoxins preparations beside the antimicrobial therapy.
Abstract: Red blood cells (RBCs) are among the most
commonly and intensively studied type of blood cells in cell biology.
Anemia is a lack of RBCs is characterized by its level compared to
the normal hemoglobin level. In this study, a system based image
processing methodology was developed to localize and extract RBCs
from microscopic images. Also, the machine learning approach is
adopted to classify the localized anemic RBCs images. Several
textural and geometrical features are calculated for each extracted
RBCs. The training set of features was analyzed using principal
component analysis (PCA). With the proposed method, RBCs were
isolated in 4.3secondsfrom an image containing 18 to 27 cells. The
reasons behind using PCA are its low computation complexity and
suitability to find the most discriminating features which can lead to
accurate classification decisions. Our classifier algorithm yielded
accuracy rates of 100%, 99.99%, and 96.50% for K-nearest neighbor
(K-NN) algorithm, support vector machine (SVM), and neural
network RBFNN, respectively. Classification was evaluated in highly
sensitivity, specificity, and kappa statistical parameters. In
conclusion, the classification results were obtained within short time
period, and the results became better when PCA was used.
Abstract: Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.
Abstract: Malaria is a serious, acute and chronic relapsing
infection to humans. It is characterized by periodic attacks of chills,
fever, nausea, vomiting, back pain, increased sweating anemia,
splenomegaly (enlargement of the spleen) and often-fatal
complications.The malaria disease is caused by the multiplication of
protozoa parasite of the genus Plasmodium. Malaria in humans is due
to 4 types of malaria parasites such that Plasmodium falciparum,
Plasmodium vivax, Plasmodium malariae and Plasmodium ovale.
P.vivax malaria differs from P. falciparum malaria in that a person
suffering from P. vivax malaria can experience relapses of the
disease. Between the relapses, the malaria parasite will remain
dormant in the liver of the patient, leading to the patient being
classified as being in the dormant class. A mathematical model for
the transmission of P. vivax is developed in which the human
population is divided into four classes, the susceptible, the infected,
the dormant and the recovered. In this paper, we formulate the
dynamical model of P. vivax malaria to see the distribution of this
disease at the district level.
Abstract: Sickle cell anemia is a recessive genetic disease
caused by the presence in the red blood cell, of abnormal hemoglobin
called hemoglobin S. It results from the replacement in the beta chain
of the acid glutamic acid by valin at position 6. Topics may be
homozygous (SS) or heterozygous (AS) most often
asymptomatic. Other mutations result in compound heterozygous:
- Synthesis of hemoglobin C mutation in the sixth leucin codon
(heterozygous SC);
- ß-thalassemia (heterozygous S-ß thalassemia).
SS homozygous, heterozygous SC and S- ß -thalassemia are grouped
under the major sickle cell syndromes.
To make a laboratory diagnosis of hemoglobinopathies in a
portion of the population in region of Batna, our study was
conducted on 115 patients with suspected sickle cell anemia, all cases
have benefited from hematological tests as blood count (count RBC,
calculated erythrocyte indices, MCV and MCHC, measuring the
hemoglobin concentration) and a biochemical test in this case
electrophoresis CAPILLARYS HEMOGLOBIN (E).
The results showed:
27 cases of sickle cell anemia were found on 115 suspected cases,
73,03% homozygous sickle cell disease and 59,25% sickle cell trait.
Finally, the double heterozygous S/C, represent the incidence rate of
3, 70%.
Abstract: Dichotomization of the outcome by a single cut-off point is an important part of various medical studies. Usually the relationship between the resulted dichotomized dependent variable and explanatory variables is analyzed with linear regression, probit regression or logistic regression. However, in many real-life situations, a certain cut-off point dividing the outcome into two groups is unknown and can be specified only approximately, i.e. surrounded by some (small) uncertainty. It means that in order to have any practical meaning the regression model must be robust to this uncertainty. In this paper, we show that neither the beta in the linear regression model, nor its significance level is robust to the small variations in the dichotomization cut-off point. As an alternative robust approach to the problem of uncertain medical categories, we propose to use the linear regression model with the fuzzy membership function as a dependent variable. This fuzzy membership function denotes to what degree the value of the underlying (continuous) outcome falls below or above the dichotomization cut-off point. In the paper, we demonstrate that the linear regression model of the fuzzy dependent variable can be insensitive against the uncertainty in the cut-off point location. In the paper we present the modeling results from the real study of low hemoglobin levels in infants. We systematically test the robustness of the binomial regression model and the linear regression model with the fuzzy dependent variable by changing the boundary for the category Anemia and show that the behavior of the latter model persists over a quite wide interval.
Abstract: Malaria is transmitted to the human by biting of
infected Anopheles mosquitoes. This disease is a serious, acute and
chronic relapsing infection to humans. Fever, nausea, vomiting, back
pain, increased sweating anemia and splenomegaly (enlargement of
the spleen) are the symptoms of the patients who infected with this
disease. It is caused by the multiplication of protozoa parasite of the
genus Plasmodium. Plasmodium falciparum, Plasmodium vivax,
Plasmodium malariae and Plasmodium ovale are the four types of
Plasmodium malaria. A mathematical model for the transmission of
Plasmodium Malaria is developed in which the human and vector
population are divided into two classes, the susceptible and the
infectious classes. In this paper, we formulate the dynamical model
of Plasmodium falciparum and Plasmodium vivax malaria. The
standard dynamical analysis is used for analyzing the behavior for
the transmission of this disease. The Threshold condition is found
and numerical results are shown to confirm the analytical results.
Abstract: The effectiveness of consuming a nutrient fortified oat drink on iron, zinc, vitamin A and vitamin C status was assessed among a cohort of school-aged Filipino children. Ultimate study implementation permitted only a within-subject comparison of change in nutritional status after four months of consuming a nutrient fortified oat drink. Thirty-eight anemic children (5-8 years) consumed an oat drink fortified with iron as NaFeEDTA, zinc, vitamin A and vitamin C for 120 days. Height, weight, serum nutrient levels, anemia status and dietary intake were assessed pre and post intervention. Thirty-four anemic children completed the intervention. After 4 months of intervention, prevalence of anemia decreased by 68% and significant improvements in iron and vitamin A status were observed. Results demonstrate the effectiveness of the fortified oat drink in alleviating anemia in young children and highlight the value of fortification programs