SlideShare a Scribd company logo
1 of 8
Download to read offline
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
1
Haematologic Indices in Pulmonary Tuberculosis with or without
HIV Co-Infection in South Eastern Nigeria
AMILO G. I1
, MELUDU S.C2
, ELE P.U3
, EZECHUKWU C4
, ONYENEKWE C1
, IFEANYI CHUKWU M1
.
DEPARTMENTS OF IMMUNOLOGY1
, BIOCHEMISTRY2
, MEDICINE3
, PAEDIATRICS. 4
NNAMDI AZIKIWE UNIVERSITY, COLLEGE OF HEALTH SCIENCES, NNEWI CAMPUS.
E-mail: Ifymilo @ yahoo.com.
ABSTRACT:
To evaluate the changes in haematologic indices in patients with pulmonary tuberculosis (PTB) with or without
Human Immune Deficiency Virus (HIV) co-infection in South Eastern Nigeria. The study population included
116 subjects (60 = males; 56 = females), recruited from 2 study centers: mile 4 Hospital Abakaliki Ebonyi State
and Nnamdi Azikiwe University, Teaching Hospital Nnewi, Anambra State, both in Nigeria. PTB + HIV (n =
20); PTB infection ( n = 27) and HIV sereopositive (n = 28). The PTB and HIV negative; control subjects were
41 (n = 41). Blood samples collected from subjects in Ethylene diamine tetra acetic acid (EDTA) container were
used for the analysis of the Haemtological cells count, packed cell volume (PCV) and Haemoglobin estimation
using routine methods as described (Dacie and Lewis, 1984). HIV screening was done with Stat pak kit and
confirmatory test by Western blot method. Erythrocyte sedimentation rate (ESR) was by Westergren method.
Haemoglobin estimation (Hb), packed cell volume (PCV) values were significantly lower in patients with PTB
(11.27±1.62 g/dl, 0.35±0.04 l/l) compared with control values (13.67±1.46 g/dl 0.41 ± 0.05 l/l) (p < 0.05).
Patients with HIV seropositive showed significantly low PCV values of (0.36 ± 0.04 l/l) compared with the
control subjects (0.41 ± 0.05 l/l) (p < 0.05). PTB patients showed higher TWBC counts (6062.5 ± 1481.83109
/l)
when compared those with HIV infection (3841.38±735.58 x 109
/l) as well as normal control value
(4363.64±551.66 x 109
/l) (p < 0.05). Male and female values compared in this work showed no significant
difference (p > 0.05). The results showed that the effect of PTB and HIV infection have caused some
haematological deregulation. It also showed that sex has little or no effect on the studied parameters.
Keywords: Pulmonary tuberculosis (PTB); Human ImmunoDeficiency Virus (HIV) and Hematologic Indices
INTRODUCTION:The past few years have witnessed a word wide resurgence of pulmonary tuberculosis
(PTB) due to Human Immuno Deficiency Virus (HIV co-infection (WHO, 2005). Tuberculosis is an old disease
of man and one of the most widespread and persistent disease of this century (1910 – 2013) (WHO. 2005). Some
reports over the past several years have indicated that while tuberculosis problem is on the wane in most
developed countries, the disease still ranks as a major health problem in the developing countries; in general and
in Africa in particular (WHO, 1982, 2008). It has been reported that Human Immunodeficiency Virus (HIV)
pandemic has caused an increase in the number of patients with PTB particularly in African and South East Asia
(Raviglone et at, 1995). A variety of factors have been identified as being predictive of a greater risk of death in
PTB patients for example, inadequate treatment, and late diagnosis of the disease, multidrug resistant,
tuberculosis and HIV infection as well as advanced age (Connoly et at, 1999). Extra pulmonary tuberculosis
(EPTB) is also on the rise with approximately ten percent (10%) of the cases involving the bone and the joints
(Putong et al, 2002). Patients with PTB may present with a variety of rheumatic symptoms and signs even
without evidence of direct muscoskeletal or local involvement PTB and systemic lupus erthematosus (SLE)
share many symtoms such as fever, myalgias, arthalgia/arthritis, rash and multi organ involvement (Watts et al,
1996).
Nigeria is a country with high incidence of tuberculosis. A recent report on the incidence in Nigeria shows there
is a prevalence rate of 19.5%. (Jemikalajah et al, 2009). Hence, there is need to review modalities of the
implementation of various components involved in control of TB. The aim of this study is to establish the
importance of haematologic parameters such as Hb, PCV, ESR, WBC, platelet count, Differential white cell
count in monitoring and management of PTB with or without HIV-co-infection.
MATERIALS AND METHODS: This study was conducted at the chest clinics of Mile 4 Abakaliki, Ebonyi
State and Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, both in Nigeria. Patients who
have tested positive for Mycobacterium tuberculosis, by Ziehl-Neelson (Z-N) stain of the sputum were recruited.
A total number of 116 subjects were recruited, (60 = males, 56 = females) from the two treatment centers: Mile 4
Hospital Abakaliki (47) Nnamdi Azikiwe University Teaching Hospital, Nnewi Campus (69). These comprised,
20 patients with pulmonary tuberculosis and HIV – co-infection (PTB + HIV), (males 10, female = 10), 27
patients with pulmonary tuberculosis (PTB) without HIV co-infection (PTB); (males = 15, females = 12), 28
patients with HIV seropositive (males = 14, females = 14), 41 apparently healthy control subjects which
comprises staff and students of the two institutions, (males = 21 females = 20).
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
2
The following haematologic parameters were carried out on EDTA anticoagulated blood samples collected from
the subjects: Haemoglobin (Hb), Packed Cell Volume (PCV), Total white blood cell count (TWBC), Platelet
count (PLT), Erythrocyte sedimentation rate (ESR), Differential white bleed cell count; neutrophils (neut),
lymphocytes (lymph), eosinophils (eosino), monocytes (mono) and basophils (baso).
Haemoglobin determination was done by cyanmethaemoglobin method, whereby haemoglobin was converted to
haemoglobin cyanide (HICN) and colour change.
Blood samples collected in EDTA container were used for the analysis of the Haematological cells count and
Haemoglobin estimation using standard method as described in (Dacie and Lewis 1984). HIV screening and
confirmatory tests were done using Stat Pak and western blot kits respectively. Stat Pak Assay-Chembio
Diagnostic system USA, Western Blot technique for confirmation using Qualicode TM HIV kit (Immunetics,
Boston USA)
TEST METHODS: Haemoglobin determination was done cymethaemoglobin method. The packed cell volume
was determined using the microhaematocrit standard method whereby EDTA blood was separated in, 4 layers
(red cells, platelets, white blood cells and plasma). The red cell layer was read with a microhaematocrit reader
and calculated as percentage of the whole blood. The total white blood cell count was done using Turk’s solution
as the diluents and was counted manually using haemacytometer (Improved Neubauer counting chamber). The
erythrocyte sedimentation rate (ESR) was done by Westergren method. The differential white blood cell count
was done using the manual method. The thin film stained by the Romanowsky method, was examined using oil
immersion objective lens (X100mm) while the proportion of the white cell types were expressed in percentage.
All the tests procedures above were as described by Dacie and Lewis (1984).
STATISTICAL ANALYSIS: Data obtained were analyzed using student t-test and ANOVA. The variables
were expressed in mean ± standard deviation (±SD) then compared. The significant difference was regarded as P
< 0.05
RESULTS: Table I shows the mean ± SD comparison of haematologic changes in PTB, PTB + HIV, HIV
seropositive patients and normal control subjects. The between comparisons among the four group: mean ± SD
Hb g/dl for PTB is 11.60±1.96, PTB + HIV = 11.29±1.6, HIV seropositive patients = 11.50±1.15, Normal
control 13.67 ± 1.46. This showed no statistical difference (F = 1.059; p > 0.05). However, mean ± SD PCV l/l
for PTB; .35 ± .07, PTB + HIV; 0.35 ± 0.04, HIV seropositive; 0.36 ± 0.05, and normal control; 0.41 ± 0.05
showed statistical significant difference among the four groups (f = 5.07, p < 0.05). The mean ± SD ESR mm/hr
compared among PTB (68.63 ± 31.81), PTB + HIV (75.00 ± 43.59), HIV seropositive patients (43.14 ± 42.37),
and control showed significant difference (F = 3.35, p < 0.05). Moreover, mean ± SD WBC x 109
g/l in PTB
(6062.5 ± 1481.83), PTB + HIV (4422.22 ± 1851.88), HIV seropositive (3841.38 ± 735.58) and normal control
(4363.64 ± 551 .66) compared showed significant difference.
Also, the mean ± SD Neutrophil % in PTB (50.63 ± 17.95); PTB + HIV (38.89 ± 17.90), HIV seropositive
(37.93 ± 15.54) and normal control (33.41 ± 8.99), the mean ± SD Lymphocyte % in PTB (40.88 ± 19.08), PTB
+ HIV (56.33 ± 17.90), HIV seropositive (55.28 ± 16.15) and normal control (60.77 ± 8.16) respectively
compared showed statistical significant difference. See table 1. However, the mean ± SD monocyte in PTB
(3.21±1.97); PTB + HIV (3.75±2.49), HIV seropositive (4.50 ± 2.81) and control (3.57 ± 1.63) when compared
were not statistically significant (F = 1.12; p>0.05). The mean ± SD compared within the groups for Hb. g/dl in
PTB and control showed statistical significant difference (p < 0.05). However, mean ± SD of the following
groups PTB and PTB + HIV, HIV seropositive and control compared applying post Hock, showed no statistical
significant difference (p > 0.05).
The mean ± SD compared within the groups applying post Hock for PCV l/l showed significant statistical
difference (p < 0.05) between PTB and control, HIV seropositive and control, PTB + HIV and control. However,
the mean ± SD post Hock comparison between PTB and PTB + HIV, HIV seropositive and PTB + HIV and PTB
and PTB + HIV respectively, showed no significant statistical difference (p > 0.05).
Also, the mean ± SD post Hock comparison of WBC x 109
g/dl showed that PTB and HIV, PTB and normal
control and HIV seropositive and normal control were statistically significant (p < 0.05). The statistical
comparison between PTB and PTB + HIV, HIV seropositive and PTB + HI, then PTB + HIV and normal control
groups in WBC x 109
g/dl show statistically no significant difference (p > 0.05).
The mean ± SD neutrophil % compared between the following: PTB and HIV, PTB and PTB + HIV, HIV
seropositive and normal control then PTB + HIV and normal control were in each case, not significantly
different (p > 0.05). Also, the mean ± SD neutrophil % compared by post Hock analysis between PTB and
normal control showed statistical significant difference (p < 0.05).
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
3
The mean ± SD Lymphocyte % compared between PTB and HIV, PTB and PTB + HIV, HIV seropositive and
PTB + HIV, HIV seropositive and control, then PTB + HIV and control show no significant difference (p >
0.05). However, mean ± SD comparison of lymphocyte % between PTB and normal control show statistical
significant difference (p < 0.05). Mean ± SD lymphocyte % comparison within all the groups: PTB and HIV
seropositive, PTB and PTB + HIV, PTB and normal control HIV seropositive and PTB + HIV, HIV seropositive
and normal control showed no significant difference (p > 0.05 in each case). (See table 1).
The mean ± SD platelet count (X109
g/dl ) values in PTB (223, 166.67 ± 56, 056 – 39), HIV seropositive
(179,666.67 ± 39831.381), PTB + HIV (191,000.00 ± 63,493.53) and control (178, 545.45 ± 34, 617.26), were
compared using ANOVA and showed significant mean difference (F = 4.81, p < 0.05). The mean ± SD
comparison of platelets between PTB and HIV seropositives, showed higher significant value in PTB (p<0.05).
Also the mean ±SD platelets count showed higher significant value in PTB compared with the controls (p<0.05).
However, the mean ± SD platelet count compared between PTB and PTB + HIV, HIV seropositive and PTB +
HIV also between HIV seropositive and control and PTB + HIV and control showed no significant difference in
values (p > 0,05) in each case.
The mean ± SD ESR mm/hr values in PTB (75.54 ± 36.71), HIV seropositive (46.89 ± 41.65); PTB + HIV
(112.75 ± 32.07), and control subjects (11.18 ± 9.75) compared using ANOVA presented statistically significant
difference (F = 24, 13; p < 0.05). Mean ± SD comparison of values in ESR using tests showed that PTB, HIV
seropositve and PTB + HIV, ESR mm/hr values were significantly higher than the values of ESR mm/hr in the
control subjects (p < 0.05) in each case. Also, PTB compared with HIV seropositive ESR mm/hr values showed
higher significant difference (p < 0.05). Also the comparison of the PTB + HIV compared with PTB showed
statistically significant difference (p < 0.05).
The mean ±SD for MCHC values in PTB (32.64 ± 1.90), HIV seropositives (32.84 ± 1.26), PTB + HIV (33.16 ±
1.95) and control (33.40 ± 1.32) compared showed no significant difference (F = 2.03; p = 0.11). Moreover,
further inter - comparison of values in parameter (MCHC) in PTB and HIV seropositive PTB and PTB + HIV,
PTB and control showed similar mean values ( p > 0.05) in each case.
Table 2, Compared the mean ± SD, Haematological changes in different groups PTB, HIV seropositive, PTB +
HIV and normal control, between male and female (in each case) using student’s t test.
The mean ± SD Hb g/dl in PTB compared between male (11.76 ± 1.95) and female (11.06 ± 1.60) showed no
statistical significant difference (p > 0.05). Also, mean ± SD PCV l/l compared between male (0.35 ± .07) and
female (0.34 ± 0.04) showed no significant difference (p > 0.05). Mean ± SD WBC x 109
/l. ESR mm/hr, in PTB
compared between male (6.25 ± 1.39, 87.67 ± 40.13) respectively and female (4.76 ± 1.06; 64.70 ± 31.00)
respectively were both not significantly different in values (p > 0.05). Moreover, the mean ± SD neutrophil %
and lymphocyte % in PTB male and female patients compared showed no statistical significant difference (p >
0.05 in each case).
The mean ± SD Hb g/dl; PCV l/l, platelet x 109
/l, WBC x 109
/l, ESR mm/hr, Neutrophil % and Lymphocyte %,
in PTB + HIV infected males and females compared (in each case), were statistically similar in value ( p > 0.05).
Also mean ± SD Hb g/dl; PCV l/l, WBC x 109
/l, ESR mm/hr, Neutrophil % and Lymphocyte % values,
compared between control male and female (in each case) resulted in statistically no significant difference (p >
0.05); On the other hand, mean ± SD, platelet count x 109
/l in PTB male (225.54 ± 54.4) compared with female
(125.6 ± 38.47) showed higher significant difference (p < 0.05). However, mean ± SD monocyte in PTB,
compared between male (1.82 ± 1.40) and female (3.91 ± 2.43) show significantly lower difference (p < 0.05).
DISCUSSION: There was a significantly lower haemoglobin level in PTB patients with and without HIV co-
infection in this study. This may be due to decreased erythrocyte lifespan, impaired marrow response or impaired
flow of iron (fe) from macrophages to the plasma in iron (fe) cycle metabolism. This decrease in haemoglobin
may also be due to a non-immune mechanism that develops secondary to granulomatous infiltration of the bone
marrow. This finding is in agreement with those of (Das et al 2003; Lawson et al 2008; Mugusi et at 2009; and
Ursavas et al 2010); who suggested a mild to moderate anaemia that frequently accompanied infections,
inflammatory and neoplastic diseases. The anaemia may reflect reticuloendothelia iron block by disease entity
and in HIV disease; partly due to suppression of erythropoiesis by cell to cell interaction (Lemoha et al 2004;
Mugasi et al 2009 and Ursavas et at, 2010).
The mean ESR in PTB and PTB + HIV patients was significantly high when compared with that of control
subjects. The reason may be due to alterations in the plasma proteins as may be the case in different entities
(Ursavas et al, 2010). Since the erythrocyte sedimentation rate is a non-specific reaction which may be compared
with the body temperature, pulse rate and the leukocyte count, it is a measure of the inflammatory response or
reaction in a disease entity.
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
4
Hence an accelerated erythrocyte sedimentation rate (ESR) is seen in patients with PTB and PTB + HIV and
HIV seropositive patients when compared with control.
So an accelerated erythrocyte sedimentation rate (ESR) may serve as a guide to the progress of disease that has
already been recognized and this being particularly true in regard to pulmonary tuberculosis (Bozoky et al, 1999
and Ursavas et al, 2010).
The total white blood cell count (WBC) of patients with PTB + HIV and PTB were significantly higher than
those of the control subjects in this study. The reason for these alterations in the blood leukocyte concentration
which in this case was due to neutrophilia is an indication of recurrent continuous inflammatory response. This
will usually change to lymphocytosis during chronic inflammatory response, the patients used for this study were
those with active tuberculosis and the findings were in agreement with those of (Jadoon et al 2004 and Ursavas
et al, 2000). The total WBC in patients with HIV seropositive in this study showed mild leucopenia. This
observed difference, might be due to the causative agent, HIV, a lentivirus, when compared with that of PTB,
caused by Mycobacterium tuberculosis. Another reason, for the leucopenia in HIV infection might be due to
decrease bone marrow production of granulocyte progenitor cells (CFUGM), colony forming unit granulocyte –
monocyte from the bone marrow of patients with HIV infection (Costello et al, 1999).
The result also showed a significant increase in monocyte count in patients with PTB and PTB + HIV. The
monocyte, a known phagocytic cell is expected to be increased in active tuberculosis infection. Hence, this
finding is in agreement with of previous authors (Bozoky et al, 1997).
There was no significant difference in lymphocyte count of patients with PTB and PTB + HIV, when compared
in each case with control. This is not in agreement with previous report by Bozoky et al, (1997) who reported
mild lymphocytosis in PTB with or without HIV co-infection. The location where this study was done may have
contributed to this different observation.
The MCHC result in this study showed low normal results; hence there is no significant difference between the
PTB, HIV seropositive and PTB + HIV with the normal control results. Although, anaemia is recorded for the
patients but the type is anaemia of chronic disorder, hence, normocytic – normochronic. This is in agreement
with previous report of Treacy et al (1984); who reported a mild anaemia in HIV/AIDS patients. It does not
agree with the report of severe anaemia with erythroid hypoplasia in HIV patients with disseminated
mycobacterium avium intracellular (MAI) infection (Gardener et al 1987).
The platelets result in this study, showed significant difference between the groups. The count in PTB is
significantly higher than those of HIV seropositive, normal control and PTB + HIV. The mean ± SD platelet
count showed no significant difference in values between PTB + HIV, HIV seropositive and control groups. This
is in agreement with previous report by Pust et al 1974, which showed there was mild thrombocytosis in
tuberculosis. The result is also in agreement with previous report by Costello et al (1999) which showed there is
mild thrombocytopenia in male and female patients with HIV. Some authors have reported presence of auto-
antibody complexes as being responsible for the mild decreased platelet count in HIV infection (Mugusi et al,
2009).
The Haematologic changes in PTB + HIV, PTB and HIV seropositive patients showed varied pictures due to the
stage of the infection and the causative agents. Mycobacterium tuberculosis and Human Immune deficiency
virus.
REFERENCES: Bozoky G, Rubye; Gher I, Toth J, Mohos A. (1997), “Haematologic Abnormalities in
pulmonary tuberculosis”. ORV. Hetil. 138 (17): 1053 -1056.
Chang S.L, Wang H.C, Yang P.C (2007), “Paradoxical response during anti-tuberculosis treatment in HIV
negative patients with pulmonary tuberculosis”. Int. J. Tuberc. Lung Dis. (11)12: 1290 – 1295.
Connoly C, Reid A; Davies G, Strum W, MC Adam K.P, Wilkinson D. (1999), “Relapse and mortality among
HIV – infected and uninfected patients with tuberculosis successfully treated with twice weekly directly
observed therapy in rural South Africa”. AIDS. 13: 1543 – 1547.
Costello (1999), “The haematological manifestation of HIV disease in Hoffbrand” A-V, Lewis S.M. Tuddeham
EGD editors. Post-graduate haematology. 4th
ed. Oxford.
England Butterworth, Das B.S, Devi U, Mohan Raoc, Srivastard VK, Heinmann Rath PK, (2003), “Effect of
Iron supplement on mild to moderate anaemia in pulmonary tuberculosis”. Br.J. Nutrition; 90(3) 541-550.
Das B.S, Dev. U, Mohan R.O.C, Srivastava V.K, Rath P.K (2003), “Effect of Iron Supplementation on mild to
moderate anaemia in pulmonary tuberculosis”. B. J. Nutrition. 90(3): 541-550.
Dacie and Lewis (1984), “Practical haematology”, 6th
Edition, Medical Division of Longman Group Ltd. pp.
470-474.
Jadoon S.M, Moir S, Ahmed T.A, Bashir MM (2004), “Smear negative pulmonary tuberculosis and lymphocyte
subsets”. J. Coll. Physicians Surg. Pak. 14(17): 419-422.
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
5
Jemikalajah D.J. and Okongwu G.R.A. (2009), “Health point prevalence of Human Immunodeficiency Virus and
Pulmonary Tuberculosis among patients in various parts of Delta State, Nigeria”. Saudi Med. J. 30: 387 – 391.
Kassu A, Tsgaye A, Petros B. (2001), “Distribution of Lymphocyte subsets in healthy human immunodeficiency
virus- negative adult Ethiopians from to geographic locales”. Clin. Diagn. Lab. Immunol. 8: 1171-1176.
Lawson L, Yassin M.A, Thather TD, Olatunyji O.O, Akingbogun I, Bellow G.S, Cuevas L.E, Davies P.D.
(2008), “Clinical presentation of adults with pulmonary tuberculosis with and without HIV co-infection in
Nigeria”. Scand J. Infect. Dis. 40 (1): 30-35.
Lemoha E., Audu R.A., Akanmu A.S. (2004), “Evaluation of Correlation between CD4 cell count and
haemoglobin in HIV-infected patients in Lagos”. Abstract presented at the 4th National Conference on
HIV/AIDS. International Conference Centre, Abuja, Nigeria.
Mugusi MF, Mehta S, Villamor E, Urassa W, Saathoff E, Bosch RJ, and Fawzi W (2009), “Factors associated
with mortality in HIV infection and uninfected patients with pulmonary tuberculosis”. B M C Public Health
Journal 12: 409
Putong N, Pitisuttithum P, Spanaranondilihp. Tansuphasawa D.S and Silachromroon U (2002), “Mycobacterium
tuberculosis infection among HIV/AIDS patients in Thailand: clinical manifestation and out comes in South East
Asia”. J. Trop. Med. Public Health 33: 346 – 350.
Raviglone M.C., Narain J.P, Kochi A. (1995) “HIV Associated tuberculosis in developing countries, clinical
features, diagnosis and treatment”. Bull. World Health Orgams. 70: 515-526.
Treacy M. (1997), “Bone Marrow Examination in HIV infection”. J. of Haem.78: 10-12.
Ursavas A, Dane E, Ridran A, Duygu K, Dilek B, Guzia K, Funda C and Ercument E. (2010), “Immune
thrombocytopenia associated with pulmonary tuberculosis”. J. infect. Chemotherapy. 16: 42 – 44.
Watts H.G, Lifeso R.M: (1996), “Tuberculosis of bones and joints”. Bone Joints Surg. Journal: 78: 288 – 298.
World Health Organization (2008), “Global TB control, Geneva. WHO/HTM/PTB /2008: WHO declares PTB
an emergency in Africa” Call for urgent and extraordinary actions to halt a worsening epidemic 340: 92 – 95.
World Health Organization (2005), “Global Tuberculosis control”. WHO/HTM/ PTB/2005, Geneva,
Switzerland, 349: 81 - 85.
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
6
Table 1:HAEMATOLOGICAL CHANGES IN PTB, HIV, PTB + HIV AND NORMAL CONTROL
SUBJECTS.
SUBJECT Hb
g/dl
PCV
l/l
ESR
mm/hr
WBC
x109
/l
Platelet
x109
/l
Neut.
%
Lymph
%
Mono
%
MCHC
1, PTB
(n=32
11.60
± 1.96
0.35 ±
0.07
75.54 ±
36.71
6062.5 ±
1481.83
223166.67 ±
56056.39
50.63
±
17.95
40.88 ±
19.08
3.21 ±
1.97
32.64 ±
1.90
2, HIV
(n=58)
11.51
± 2.15
0.36 ±
0.05
46.89 ±
41.65
3841.38
± 735.58
179666.67 ±
39831.38
37.93
±
15.54
55.28 ±
16.15
4.50 ±
2.81
32.84 ±
1.26
3,
PTB+HIV
(n=20)
11.27
± 1.62
0.35 ±
0.04
112.75
± 32.07
4422.22
±
1851.88
191000.00 ±
63,493.53
38.89
±
17.95
56.33 ±
17.90
3.75 ±
2.49
33.16 ±
1.95
4, Control
(n=40)
13.67
± 1.46
0.41 ±
0.05
11.18 ±
9.75
4363.64
± 551.66
178545.45 ±
34617.26
53.41
± 8.99
60.77 ±
8.16
3.57 ±
1.63
33.40 ±
1.32
F (p) Value 1.059
0.37
5.07
0.003
24.13
0.043
15.25
0.00
4.81
0.004
4.34
0.007
5.54
0.002
1.12
0.35
2.03
(0.11)
1 vs. 2 p
Value
0.41 0.96 0.06 0.00 0.02 0.11 0.074 0.36 0.38
1vs. 3 p
Value
0.97 0.99 0.07 0.15 0.60 0.42 0.22 0.95 0.91
1 vs. 4 “ 0.007 0.044 0.00 0.002 0.01 0.01 0.005 0.94 0.06
2 vs. 3 “ 0.37 0.86 0.00 0.80 1.96 1.0 1.0 0.89 0.81
2 vs. 4 “ 0.74 0.007 0.00 0.33 1.00 0.56 0.40 0.52 0.92
3 vs. 4 “
0.009
0.017 0.00 1.0 0.95 0.82 0.89 0.97 0.36
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.11, 2013
7
Table 2:Haematologic Changes in Different Groups: PTB, PTB + HIV, HIV Seropositive and Normal
Control compared between sexes (male and female) using student’s t tests.
S/N SUBJECT Hb
g/dl
PCV
l/l
WBC
x109
/l
ESR
mm/hr
Mono
%
Neut
%
Lymph
%
Platelets
x109
/l
1 PTB – HIV male
(n=30)
11.76
±
1.95
0.35
±
0.07
6.25 ±
1.39
87.67 ±
40.13
1.82 ±
1.40
50.87
±
16.66
41.40 ±
16.77
244.33±46.39
2 PTB – HIV
female (n=20)
11.06
±
1.60
0.34
±
0.04
4.76 ±
1.06
64.70 ±
31.00
3.91 ±
2.43
39.70
±
19.92
54.00 ±
22.39
233.55±67.16
3 PTB–HIV
male/female
P-value
0.97 0.99 0.09 0.74 0.03 0.82 0.79 0.69
4 PTB + HIV male
(n=10)
10.36
± 5.1
0.33
±
0.05
5.46 ±
1.24
131.00
± 74.20
1.67 ±
1.53
43.00
±
21.42
51.60 ±
40.85
164.08±33.07
5 PTB + HIV
female (n=6)
12.80
±
0.53
0.37
±
0.02
4.30 ±
0.61
60.00 ±
34.64
3.67 ±
3.06
30.67
±
14.19
67.00 ±
12.12
184.58±42.68
6 PTB + HIV
male/female
0.16 0.85 0.66 0.63 0.32 0.96 0.87 0.19
7 HIVseropositive
male
(n=24)
13.12
±
1.84
0.39
±
0.05
3.68 ±
0.60
32.92 ±
37.50
3.42 ±
2.71
33.83
±
15.41
60.42 ±
16.78
225.40±54.5
8 HIV seropositive
female (n=30)
11.24
±
1.54
0.34
±
0.04
4.0 ±
0.90
54.73 ±
46.44
3.83 ±
3.27
40.67
±
16.47
51.60 ±
16.10
125.60±38.47
9 HIV male/female
P.Value
0.14 0.17 0.96 0.87 0.74 0.95 0.86 0.02
10 Control male
(n=22)
14.78
±
1.05
0.43
±
0.04
4.11 ±
0.45
7.73 ±
5.62
2.64 ±
1.69
33.27
± 7.76
61.00 ±
4.45
169.09±36.61
11 Control female
(n=18)
12.56
± .83
0.38
± .o4
4.54 ±
.04
14.64 ±
11.91
4.18 ±
1.54
33.54
±
10.49
60.55 ±
10.95
188.00±31.30
12 Control male /
female
P Value
0.001 0.06 .71 .67 0.08 1.00 1.00 0.16
This academic article was published by The International Institute for Science,
Technology and Education (IISTE). The IISTE is a pioneer in the Open Access
Publishing service based in the U.S. and Europe. The aim of the institute is
Accelerating Global Knowledge Sharing.
More information about the publisher can be found in the IISTE’s homepage:
http://www.iiste.org
CALL FOR JOURNAL PAPERS
The IISTE is currently hosting more than 30 peer-reviewed academic journals and
collaborating with academic institutions around the world. There’s no deadline for
submission. Prospective authors of IISTE journals can find the submission
instruction on the following page: http://www.iiste.org/journals/ The IISTE
editorial team promises to the review and publish all the qualified submissions in a
fast manner. All the journals articles are available online to the readers all over the
world without financial, legal, or technical barriers other than those inseparable from
gaining access to the internet itself. Printed version of the journals is also available
upon request of readers and authors.
MORE RESOURCES
Book publication information: http://www.iiste.org/book/
Recent conferences: http://www.iiste.org/conference/
IISTE Knowledge Sharing Partners
EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open
Archives Harvester, Bielefeld Academic Search Engine, Elektronische
Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial
Library , NewJour, Google Scholar

More Related Content

What's hot

Graft versus Tumour effect
Graft versus Tumour effectGraft versus Tumour effect
Graft versus Tumour effectmeducationdotnet
 
TAEM10: How To Help Copd Patients Feel Better And
TAEM10: How To Help Copd Patients Feel Better AndTAEM10: How To Help Copd Patients Feel Better And
TAEM10: How To Help Copd Patients Feel Better Andtaem
 
eosinophilic gastroenteritis
 eosinophilic gastroenteritis eosinophilic gastroenteritis
eosinophilic gastroenteritiscesar gaytan
 
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...spa718
 
Donor Lymphocyte Infusion: Dr. Chenhua Yan
Donor Lymphocyte Infusion: Dr. Chenhua YanDonor Lymphocyte Infusion: Dr. Chenhua Yan
Donor Lymphocyte Infusion: Dr. Chenhua Yanspa718
 
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...Rodrigo Vargas Zapana
 
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamento
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamentoAnemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamento
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamentoanemo_site
 
Post transplant erythrocytosis
Post transplant erythrocytosisPost transplant erythrocytosis
Post transplant erythrocytosisPatricia Khashayar
 
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...Bladimir Viloria
 
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...inventionjournals
 
Journal club 72010
Journal club 72010Journal club 72010
Journal club 72010Ahad Lodhi
 
Obesity & Asthma Journal
Obesity & Asthma JournalObesity & Asthma Journal
Obesity & Asthma Journalliza mariposque
 

What's hot (20)

The State of Scleroderma Clinical Trials
The State of Scleroderma Clinical TrialsThe State of Scleroderma Clinical Trials
The State of Scleroderma Clinical Trials
 
Scleroderma Interstitial Lung Disease: What's New?
Scleroderma Interstitial Lung Disease: What's New?Scleroderma Interstitial Lung Disease: What's New?
Scleroderma Interstitial Lung Disease: What's New?
 
Clots and Zealots
Clots and ZealotsClots and Zealots
Clots and Zealots
 
Graft versus Tumour effect
Graft versus Tumour effectGraft versus Tumour effect
Graft versus Tumour effect
 
TAEM10: How To Help Copd Patients Feel Better And
TAEM10: How To Help Copd Patients Feel Better AndTAEM10: How To Help Copd Patients Feel Better And
TAEM10: How To Help Copd Patients Feel Better And
 
eosinophilic gastroenteritis
 eosinophilic gastroenteritis eosinophilic gastroenteritis
eosinophilic gastroenteritis
 
Gram negative slideset
Gram negative slidesetGram negative slideset
Gram negative slideset
 
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...
Donor Lymphocyte Infusion in Patients with Hematological Malignancies after T...
 
7
77
7
 
Donor Lymphocyte Infusion: Dr. Chenhua Yan
Donor Lymphocyte Infusion: Dr. Chenhua YanDonor Lymphocyte Infusion: Dr. Chenhua Yan
Donor Lymphocyte Infusion: Dr. Chenhua Yan
 
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...
Benefits os Statins in Elderly Subjects Without Established Cardiovascular Di...
 
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamento
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamentoAnemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamento
Anemo 2010 - Inghilleri - Anemie preoperatorie valutazione e trattamento
 
Wiedermann isicem 2013 where are we now
Wiedermann isicem 2013 where are we nowWiedermann isicem 2013 where are we now
Wiedermann isicem 2013 where are we now
 
Post transplant erythrocytosis
Post transplant erythrocytosisPost transplant erythrocytosis
Post transplant erythrocytosis
 
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...
Nonfasting Glucose, Ischemic Heart Disease, and Myocardial Infarction A Mende...
 
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...
Efficiency of Use of Dietary Supplement Arteroprotect® In Prevention of Cardi...
 
Ojchd.000542
Ojchd.000542Ojchd.000542
Ojchd.000542
 
Journal club 72010
Journal club 72010Journal club 72010
Journal club 72010
 
Rare Pulmonary Diseases in Systemic JIA
Rare Pulmonary Diseases in Systemic JIARare Pulmonary Diseases in Systemic JIA
Rare Pulmonary Diseases in Systemic JIA
 
Obesity & Asthma Journal
Obesity & Asthma JournalObesity & Asthma Journal
Obesity & Asthma Journal
 

Viewers also liked

Pathophysiology Of Pulmonary Tuberculosis
Pathophysiology Of Pulmonary TuberculosisPathophysiology Of Pulmonary Tuberculosis
Pathophysiology Of Pulmonary TuberculosisJack Frost
 
4.Pulmonary Tuberculosis
4.Pulmonary Tuberculosis 4.Pulmonary Tuberculosis
4.Pulmonary Tuberculosis ghalan
 
Wallgren timetable of primary tb
Wallgren timetable of primary tbWallgren timetable of primary tb
Wallgren timetable of primary tbYapa
 
Diagnosis of Pulmonary Tuberculosis
Diagnosis of Pulmonary TuberculosisDiagnosis of Pulmonary Tuberculosis
Diagnosis of Pulmonary TuberculosisJack Frost
 
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku Joseph
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku JosephBasic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku Joseph
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku JosephDr.Tinku Joseph
 
Basic pulmonary tuberculosis intro
Basic pulmonary tuberculosis introBasic pulmonary tuberculosis intro
Basic pulmonary tuberculosis introKochi Chia
 
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENT
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENTDRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENT
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENTDr.Lalit Kumar
 
Mdr tb & xdr tb ppt.
Mdr tb & xdr tb ppt. Mdr tb & xdr tb ppt.
Mdr tb & xdr tb ppt. Silajit Dutta
 
Revised national tuberculosis control programme
Revised national tuberculosis control programmeRevised national tuberculosis control programme
Revised national tuberculosis control programmeRavi Rohilla
 
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)Vivek Varat
 
WHO and RNTCP guidelines - Tuberculosis management
WHO and RNTCP guidelines - Tuberculosis managementWHO and RNTCP guidelines - Tuberculosis management
WHO and RNTCP guidelines - Tuberculosis managementDr. Pratyush Kumar
 

Viewers also liked (20)

Dr Ashish Yadav
Dr Ashish YadavDr Ashish Yadav
Dr Ashish Yadav
 
Pulmonary TB
Pulmonary TBPulmonary TB
Pulmonary TB
 
Bleeding tendency
Bleeding tendencyBleeding tendency
Bleeding tendency
 
Pathophysiology Of Pulmonary Tuberculosis
Pathophysiology Of Pulmonary TuberculosisPathophysiology Of Pulmonary Tuberculosis
Pathophysiology Of Pulmonary Tuberculosis
 
Tb path & pathogenesis
Tb path & pathogenesis Tb path & pathogenesis
Tb path & pathogenesis
 
4.Pulmonary Tuberculosis
4.Pulmonary Tuberculosis 4.Pulmonary Tuberculosis
4.Pulmonary Tuberculosis
 
Wallgren timetable of primary tb
Wallgren timetable of primary tbWallgren timetable of primary tb
Wallgren timetable of primary tb
 
Diagnosis of Pulmonary Tuberculosis
Diagnosis of Pulmonary TuberculosisDiagnosis of Pulmonary Tuberculosis
Diagnosis of Pulmonary Tuberculosis
 
Mdr tuberculosis
Mdr tuberculosisMdr tuberculosis
Mdr tuberculosis
 
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku Joseph
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku JosephBasic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku Joseph
Basic concepts in treatment of Pulmonary Tuberculosis - By Dr.Tinku Joseph
 
Basic pulmonary tuberculosis intro
Basic pulmonary tuberculosis introBasic pulmonary tuberculosis intro
Basic pulmonary tuberculosis intro
 
4.Dots
4.Dots4.Dots
4.Dots
 
Tb management 2016
Tb management 2016Tb management 2016
Tb management 2016
 
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENT
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENTDRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENT
DRUG RESISTANT TUBERCULOSIS,DIAGNOSIS AND TREATMENT
 
Mdr tb & xdr tb ppt.
Mdr tb & xdr tb ppt. Mdr tb & xdr tb ppt.
Mdr tb & xdr tb ppt.
 
Revised national tuberculosis control programme
Revised national tuberculosis control programmeRevised national tuberculosis control programme
Revised national tuberculosis control programme
 
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
 
WHO and RNTCP guidelines - Tuberculosis management
WHO and RNTCP guidelines - Tuberculosis managementWHO and RNTCP guidelines - Tuberculosis management
WHO and RNTCP guidelines - Tuberculosis management
 
Pathogenesis of tuberculosis
Pathogenesis of tuberculosis Pathogenesis of tuberculosis
Pathogenesis of tuberculosis
 
Tuberculosis
TuberculosisTuberculosis
Tuberculosis
 

Similar to Haematologic indices in pulmonary tuberculosis with or without

11.some haematological parameters of tuberculosis (tb) infected africans
11.some haematological parameters of tuberculosis (tb) infected africans11.some haematological parameters of tuberculosis (tb) infected africans
11.some haematological parameters of tuberculosis (tb) infected africansAlexander Decker
 
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...paperpublications3
 
Thrombocytopenia in HIV/AIDS
Thrombocytopenia in HIV/AIDSThrombocytopenia in HIV/AIDS
Thrombocytopenia in HIV/AIDSiosrjce
 
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
 
The study to measure the level of serum annexin V in patients with renal hype...
The study to measure the level of serum annexin V in patients with renal hype...The study to measure the level of serum annexin V in patients with renal hype...
The study to measure the level of serum annexin V in patients with renal hype...inventionjournals
 
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...iosrphr_editor
 
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...iosrjce
 
Intraepithelial lymphocyte distribution differs between the bulb and the seco...
Intraepithelial lymphocyte distribution differs between the bulb and the seco...Intraepithelial lymphocyte distribution differs between the bulb and the seco...
Intraepithelial lymphocyte distribution differs between the bulb and the seco...Enrique Moreno Gonzalez
 
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...Red cell alloimmunization in blood transfusion dependent Patients with Sickle...
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...iosrjce
 
POISON CONTROL CENTRE
POISON CONTROL CENTREPOISON CONTROL CENTRE
POISON CONTROL CENTREMUSHTAQ AHMED
 
IJSRED-V2I1P1
IJSRED-V2I1P1IJSRED-V2I1P1
IJSRED-V2I1P1IJSRED
 
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY - Dr. Kapil Amgain
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY -  Dr. Kapil Amgain GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY -  Dr. Kapil Amgain
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY - Dr. Kapil Amgain DrKapilAmgain
 
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...IOSRJPBS
 
Factors associated with development of vitiligo in patients with halo nevus
Factors associated with development of vitiligo in patients with halo nevusFactors associated with development of vitiligo in patients with halo nevus
Factors associated with development of vitiligo in patients with halo nevustloanphan
 

Similar to Haematologic indices in pulmonary tuberculosis with or without (20)

11.some haematological parameters of tuberculosis (tb) infected africans
11.some haematological parameters of tuberculosis (tb) infected africans11.some haematological parameters of tuberculosis (tb) infected africans
11.some haematological parameters of tuberculosis (tb) infected africans
 
000010 tpi en vih
000010 tpi en vih000010 tpi en vih
000010 tpi en vih
 
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...
Assessment of Renal Function and Serum Levels of Alpha Tocopherol in HIV Sero...
 
Thrombocytopenia in HIV/AIDS
Thrombocytopenia in HIV/AIDSThrombocytopenia in HIV/AIDS
Thrombocytopenia in HIV/AIDS
 
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...
 
Association between Blood Group Antigens, CD4 Cell Count and Haemoglobin Elec...
Association between Blood Group Antigens, CD4 Cell Count and Haemoglobin Elec...Association between Blood Group Antigens, CD4 Cell Count and Haemoglobin Elec...
Association between Blood Group Antigens, CD4 Cell Count and Haemoglobin Elec...
 
The study to measure the level of serum annexin V in patients with renal hype...
The study to measure the level of serum annexin V in patients with renal hype...The study to measure the level of serum annexin V in patients with renal hype...
The study to measure the level of serum annexin V in patients with renal hype...
 
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...
 
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
 
Intraepithelial lymphocyte distribution differs between the bulb and the seco...
Intraepithelial lymphocyte distribution differs between the bulb and the seco...Intraepithelial lymphocyte distribution differs between the bulb and the seco...
Intraepithelial lymphocyte distribution differs between the bulb and the seco...
 
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...Red cell alloimmunization in blood transfusion dependent Patients with Sickle...
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...
 
High Prevalence of Diabetes Mellitus among Adult Patients with Viral Hepatiti...
High Prevalence of Diabetes Mellitus among Adult Patients with Viral Hepatiti...High Prevalence of Diabetes Mellitus among Adult Patients with Viral Hepatiti...
High Prevalence of Diabetes Mellitus among Adult Patients with Viral Hepatiti...
 
Zoellner_AnnofHem
Zoellner_AnnofHemZoellner_AnnofHem
Zoellner_AnnofHem
 
POISON CONTROL CENTRE
POISON CONTROL CENTREPOISON CONTROL CENTRE
POISON CONTROL CENTRE
 
IJSRED-V2I1P1
IJSRED-V2I1P1IJSRED-V2I1P1
IJSRED-V2I1P1
 
non invasive
non invasivenon invasive
non invasive
 
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY - Dr. Kapil Amgain
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY -  Dr. Kapil Amgain GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY -  Dr. Kapil Amgain
GENDER DIFFERENCE ON CASE DETECTION OF PULMONARY - Dr. Kapil Amgain
 
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...
Study of Some Serological Markers (Hbs Ag, Anti-Hbs and AntHbc Igm) for Detec...
 
73rd Publication- JPBS- 7th Name.pdf
73rd Publication- JPBS- 7th Name.pdf73rd Publication- JPBS- 7th Name.pdf
73rd Publication- JPBS- 7th Name.pdf
 
Factors associated with development of vitiligo in patients with halo nevus
Factors associated with development of vitiligo in patients with halo nevusFactors associated with development of vitiligo in patients with halo nevus
Factors associated with development of vitiligo in patients with halo nevus
 

More from Alexander Decker

Abnormalities of hormones and inflammatory cytokines in women affected with p...
Abnormalities of hormones and inflammatory cytokines in women affected with p...Abnormalities of hormones and inflammatory cytokines in women affected with p...
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
 
A validation of the adverse childhood experiences scale in
A validation of the adverse childhood experiences scale inA validation of the adverse childhood experiences scale in
A validation of the adverse childhood experiences scale inAlexander Decker
 
A usability evaluation framework for b2 c e commerce websites
A usability evaluation framework for b2 c e commerce websitesA usability evaluation framework for b2 c e commerce websites
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
 
A universal model for managing the marketing executives in nigerian banks
A universal model for managing the marketing executives in nigerian banksA universal model for managing the marketing executives in nigerian banks
A universal model for managing the marketing executives in nigerian banksAlexander Decker
 
A unique common fixed point theorems in generalized d
A unique common fixed point theorems in generalized dA unique common fixed point theorems in generalized d
A unique common fixed point theorems in generalized dAlexander Decker
 
A trends of salmonella and antibiotic resistance
A trends of salmonella and antibiotic resistanceA trends of salmonella and antibiotic resistance
A trends of salmonella and antibiotic resistanceAlexander Decker
 
A transformational generative approach towards understanding al-istifham
A transformational  generative approach towards understanding al-istifhamA transformational  generative approach towards understanding al-istifham
A transformational generative approach towards understanding al-istifhamAlexander Decker
 
A time series analysis of the determinants of savings in namibia
A time series analysis of the determinants of savings in namibiaA time series analysis of the determinants of savings in namibia
A time series analysis of the determinants of savings in namibiaAlexander Decker
 
A therapy for physical and mental fitness of school children
A therapy for physical and mental fitness of school childrenA therapy for physical and mental fitness of school children
A therapy for physical and mental fitness of school childrenAlexander Decker
 
A theory of efficiency for managing the marketing executives in nigerian banks
A theory of efficiency for managing the marketing executives in nigerian banksA theory of efficiency for managing the marketing executives in nigerian banks
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
 
A systematic evaluation of link budget for
A systematic evaluation of link budget forA systematic evaluation of link budget for
A systematic evaluation of link budget forAlexander Decker
 
A synthetic review of contraceptive supplies in punjab
A synthetic review of contraceptive supplies in punjabA synthetic review of contraceptive supplies in punjab
A synthetic review of contraceptive supplies in punjabAlexander Decker
 
A synthesis of taylor’s and fayol’s management approaches for managing market...
A synthesis of taylor’s and fayol’s management approaches for managing market...A synthesis of taylor’s and fayol’s management approaches for managing market...
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
 
A survey paper on sequence pattern mining with incremental
A survey paper on sequence pattern mining with incrementalA survey paper on sequence pattern mining with incremental
A survey paper on sequence pattern mining with incrementalAlexander Decker
 
A survey on live virtual machine migrations and its techniques
A survey on live virtual machine migrations and its techniquesA survey on live virtual machine migrations and its techniques
A survey on live virtual machine migrations and its techniquesAlexander Decker
 
A survey on data mining and analysis in hadoop and mongo db
A survey on data mining and analysis in hadoop and mongo dbA survey on data mining and analysis in hadoop and mongo db
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
 
A survey on challenges to the media cloud
A survey on challenges to the media cloudA survey on challenges to the media cloud
A survey on challenges to the media cloudAlexander Decker
 
A survey of provenance leveraged
A survey of provenance leveragedA survey of provenance leveraged
A survey of provenance leveragedAlexander Decker
 
A survey of private equity investments in kenya
A survey of private equity investments in kenyaA survey of private equity investments in kenya
A survey of private equity investments in kenyaAlexander Decker
 
A study to measures the financial health of
A study to measures the financial health ofA study to measures the financial health of
A study to measures the financial health ofAlexander Decker
 

More from Alexander Decker (20)

Abnormalities of hormones and inflammatory cytokines in women affected with p...
Abnormalities of hormones and inflammatory cytokines in women affected with p...Abnormalities of hormones and inflammatory cytokines in women affected with p...
Abnormalities of hormones and inflammatory cytokines in women affected with p...
 
A validation of the adverse childhood experiences scale in
A validation of the adverse childhood experiences scale inA validation of the adverse childhood experiences scale in
A validation of the adverse childhood experiences scale in
 
A usability evaluation framework for b2 c e commerce websites
A usability evaluation framework for b2 c e commerce websitesA usability evaluation framework for b2 c e commerce websites
A usability evaluation framework for b2 c e commerce websites
 
A universal model for managing the marketing executives in nigerian banks
A universal model for managing the marketing executives in nigerian banksA universal model for managing the marketing executives in nigerian banks
A universal model for managing the marketing executives in nigerian banks
 
A unique common fixed point theorems in generalized d
A unique common fixed point theorems in generalized dA unique common fixed point theorems in generalized d
A unique common fixed point theorems in generalized d
 
A trends of salmonella and antibiotic resistance
A trends of salmonella and antibiotic resistanceA trends of salmonella and antibiotic resistance
A trends of salmonella and antibiotic resistance
 
A transformational generative approach towards understanding al-istifham
A transformational  generative approach towards understanding al-istifhamA transformational  generative approach towards understanding al-istifham
A transformational generative approach towards understanding al-istifham
 
A time series analysis of the determinants of savings in namibia
A time series analysis of the determinants of savings in namibiaA time series analysis of the determinants of savings in namibia
A time series analysis of the determinants of savings in namibia
 
A therapy for physical and mental fitness of school children
A therapy for physical and mental fitness of school childrenA therapy for physical and mental fitness of school children
A therapy for physical and mental fitness of school children
 
A theory of efficiency for managing the marketing executives in nigerian banks
A theory of efficiency for managing the marketing executives in nigerian banksA theory of efficiency for managing the marketing executives in nigerian banks
A theory of efficiency for managing the marketing executives in nigerian banks
 
A systematic evaluation of link budget for
A systematic evaluation of link budget forA systematic evaluation of link budget for
A systematic evaluation of link budget for
 
A synthetic review of contraceptive supplies in punjab
A synthetic review of contraceptive supplies in punjabA synthetic review of contraceptive supplies in punjab
A synthetic review of contraceptive supplies in punjab
 
A synthesis of taylor’s and fayol’s management approaches for managing market...
A synthesis of taylor’s and fayol’s management approaches for managing market...A synthesis of taylor’s and fayol’s management approaches for managing market...
A synthesis of taylor’s and fayol’s management approaches for managing market...
 
A survey paper on sequence pattern mining with incremental
A survey paper on sequence pattern mining with incrementalA survey paper on sequence pattern mining with incremental
A survey paper on sequence pattern mining with incremental
 
A survey on live virtual machine migrations and its techniques
A survey on live virtual machine migrations and its techniquesA survey on live virtual machine migrations and its techniques
A survey on live virtual machine migrations and its techniques
 
A survey on data mining and analysis in hadoop and mongo db
A survey on data mining and analysis in hadoop and mongo dbA survey on data mining and analysis in hadoop and mongo db
A survey on data mining and analysis in hadoop and mongo db
 
A survey on challenges to the media cloud
A survey on challenges to the media cloudA survey on challenges to the media cloud
A survey on challenges to the media cloud
 
A survey of provenance leveraged
A survey of provenance leveragedA survey of provenance leveraged
A survey of provenance leveraged
 
A survey of private equity investments in kenya
A survey of private equity investments in kenyaA survey of private equity investments in kenya
A survey of private equity investments in kenya
 
A study to measures the financial health of
A study to measures the financial health ofA study to measures the financial health of
A study to measures the financial health of
 

Recently uploaded

Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...narwatsonia7
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiAlinaDevecerski
 
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls JaipurRussian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 

Recently uploaded (20)

Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
 
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls JaipurRussian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 

Haematologic indices in pulmonary tuberculosis with or without

  • 1. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 1 Haematologic Indices in Pulmonary Tuberculosis with or without HIV Co-Infection in South Eastern Nigeria AMILO G. I1 , MELUDU S.C2 , ELE P.U3 , EZECHUKWU C4 , ONYENEKWE C1 , IFEANYI CHUKWU M1 . DEPARTMENTS OF IMMUNOLOGY1 , BIOCHEMISTRY2 , MEDICINE3 , PAEDIATRICS. 4 NNAMDI AZIKIWE UNIVERSITY, COLLEGE OF HEALTH SCIENCES, NNEWI CAMPUS. E-mail: Ifymilo @ yahoo.com. ABSTRACT: To evaluate the changes in haematologic indices in patients with pulmonary tuberculosis (PTB) with or without Human Immune Deficiency Virus (HIV) co-infection in South Eastern Nigeria. The study population included 116 subjects (60 = males; 56 = females), recruited from 2 study centers: mile 4 Hospital Abakaliki Ebonyi State and Nnamdi Azikiwe University, Teaching Hospital Nnewi, Anambra State, both in Nigeria. PTB + HIV (n = 20); PTB infection ( n = 27) and HIV sereopositive (n = 28). The PTB and HIV negative; control subjects were 41 (n = 41). Blood samples collected from subjects in Ethylene diamine tetra acetic acid (EDTA) container were used for the analysis of the Haemtological cells count, packed cell volume (PCV) and Haemoglobin estimation using routine methods as described (Dacie and Lewis, 1984). HIV screening was done with Stat pak kit and confirmatory test by Western blot method. Erythrocyte sedimentation rate (ESR) was by Westergren method. Haemoglobin estimation (Hb), packed cell volume (PCV) values were significantly lower in patients with PTB (11.27±1.62 g/dl, 0.35±0.04 l/l) compared with control values (13.67±1.46 g/dl 0.41 ± 0.05 l/l) (p < 0.05). Patients with HIV seropositive showed significantly low PCV values of (0.36 ± 0.04 l/l) compared with the control subjects (0.41 ± 0.05 l/l) (p < 0.05). PTB patients showed higher TWBC counts (6062.5 ± 1481.83109 /l) when compared those with HIV infection (3841.38±735.58 x 109 /l) as well as normal control value (4363.64±551.66 x 109 /l) (p < 0.05). Male and female values compared in this work showed no significant difference (p > 0.05). The results showed that the effect of PTB and HIV infection have caused some haematological deregulation. It also showed that sex has little or no effect on the studied parameters. Keywords: Pulmonary tuberculosis (PTB); Human ImmunoDeficiency Virus (HIV) and Hematologic Indices INTRODUCTION:The past few years have witnessed a word wide resurgence of pulmonary tuberculosis (PTB) due to Human Immuno Deficiency Virus (HIV co-infection (WHO, 2005). Tuberculosis is an old disease of man and one of the most widespread and persistent disease of this century (1910 – 2013) (WHO. 2005). Some reports over the past several years have indicated that while tuberculosis problem is on the wane in most developed countries, the disease still ranks as a major health problem in the developing countries; in general and in Africa in particular (WHO, 1982, 2008). It has been reported that Human Immunodeficiency Virus (HIV) pandemic has caused an increase in the number of patients with PTB particularly in African and South East Asia (Raviglone et at, 1995). A variety of factors have been identified as being predictive of a greater risk of death in PTB patients for example, inadequate treatment, and late diagnosis of the disease, multidrug resistant, tuberculosis and HIV infection as well as advanced age (Connoly et at, 1999). Extra pulmonary tuberculosis (EPTB) is also on the rise with approximately ten percent (10%) of the cases involving the bone and the joints (Putong et al, 2002). Patients with PTB may present with a variety of rheumatic symptoms and signs even without evidence of direct muscoskeletal or local involvement PTB and systemic lupus erthematosus (SLE) share many symtoms such as fever, myalgias, arthalgia/arthritis, rash and multi organ involvement (Watts et al, 1996). Nigeria is a country with high incidence of tuberculosis. A recent report on the incidence in Nigeria shows there is a prevalence rate of 19.5%. (Jemikalajah et al, 2009). Hence, there is need to review modalities of the implementation of various components involved in control of TB. The aim of this study is to establish the importance of haematologic parameters such as Hb, PCV, ESR, WBC, platelet count, Differential white cell count in monitoring and management of PTB with or without HIV-co-infection. MATERIALS AND METHODS: This study was conducted at the chest clinics of Mile 4 Abakaliki, Ebonyi State and Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, both in Nigeria. Patients who have tested positive for Mycobacterium tuberculosis, by Ziehl-Neelson (Z-N) stain of the sputum were recruited. A total number of 116 subjects were recruited, (60 = males, 56 = females) from the two treatment centers: Mile 4 Hospital Abakaliki (47) Nnamdi Azikiwe University Teaching Hospital, Nnewi Campus (69). These comprised, 20 patients with pulmonary tuberculosis and HIV – co-infection (PTB + HIV), (males 10, female = 10), 27 patients with pulmonary tuberculosis (PTB) without HIV co-infection (PTB); (males = 15, females = 12), 28 patients with HIV seropositive (males = 14, females = 14), 41 apparently healthy control subjects which comprises staff and students of the two institutions, (males = 21 females = 20).
  • 2. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 2 The following haematologic parameters were carried out on EDTA anticoagulated blood samples collected from the subjects: Haemoglobin (Hb), Packed Cell Volume (PCV), Total white blood cell count (TWBC), Platelet count (PLT), Erythrocyte sedimentation rate (ESR), Differential white bleed cell count; neutrophils (neut), lymphocytes (lymph), eosinophils (eosino), monocytes (mono) and basophils (baso). Haemoglobin determination was done by cyanmethaemoglobin method, whereby haemoglobin was converted to haemoglobin cyanide (HICN) and colour change. Blood samples collected in EDTA container were used for the analysis of the Haematological cells count and Haemoglobin estimation using standard method as described in (Dacie and Lewis 1984). HIV screening and confirmatory tests were done using Stat Pak and western blot kits respectively. Stat Pak Assay-Chembio Diagnostic system USA, Western Blot technique for confirmation using Qualicode TM HIV kit (Immunetics, Boston USA) TEST METHODS: Haemoglobin determination was done cymethaemoglobin method. The packed cell volume was determined using the microhaematocrit standard method whereby EDTA blood was separated in, 4 layers (red cells, platelets, white blood cells and plasma). The red cell layer was read with a microhaematocrit reader and calculated as percentage of the whole blood. The total white blood cell count was done using Turk’s solution as the diluents and was counted manually using haemacytometer (Improved Neubauer counting chamber). The erythrocyte sedimentation rate (ESR) was done by Westergren method. The differential white blood cell count was done using the manual method. The thin film stained by the Romanowsky method, was examined using oil immersion objective lens (X100mm) while the proportion of the white cell types were expressed in percentage. All the tests procedures above were as described by Dacie and Lewis (1984). STATISTICAL ANALYSIS: Data obtained were analyzed using student t-test and ANOVA. The variables were expressed in mean ± standard deviation (±SD) then compared. The significant difference was regarded as P < 0.05 RESULTS: Table I shows the mean ± SD comparison of haematologic changes in PTB, PTB + HIV, HIV seropositive patients and normal control subjects. The between comparisons among the four group: mean ± SD Hb g/dl for PTB is 11.60±1.96, PTB + HIV = 11.29±1.6, HIV seropositive patients = 11.50±1.15, Normal control 13.67 ± 1.46. This showed no statistical difference (F = 1.059; p > 0.05). However, mean ± SD PCV l/l for PTB; .35 ± .07, PTB + HIV; 0.35 ± 0.04, HIV seropositive; 0.36 ± 0.05, and normal control; 0.41 ± 0.05 showed statistical significant difference among the four groups (f = 5.07, p < 0.05). The mean ± SD ESR mm/hr compared among PTB (68.63 ± 31.81), PTB + HIV (75.00 ± 43.59), HIV seropositive patients (43.14 ± 42.37), and control showed significant difference (F = 3.35, p < 0.05). Moreover, mean ± SD WBC x 109 g/l in PTB (6062.5 ± 1481.83), PTB + HIV (4422.22 ± 1851.88), HIV seropositive (3841.38 ± 735.58) and normal control (4363.64 ± 551 .66) compared showed significant difference. Also, the mean ± SD Neutrophil % in PTB (50.63 ± 17.95); PTB + HIV (38.89 ± 17.90), HIV seropositive (37.93 ± 15.54) and normal control (33.41 ± 8.99), the mean ± SD Lymphocyte % in PTB (40.88 ± 19.08), PTB + HIV (56.33 ± 17.90), HIV seropositive (55.28 ± 16.15) and normal control (60.77 ± 8.16) respectively compared showed statistical significant difference. See table 1. However, the mean ± SD monocyte in PTB (3.21±1.97); PTB + HIV (3.75±2.49), HIV seropositive (4.50 ± 2.81) and control (3.57 ± 1.63) when compared were not statistically significant (F = 1.12; p>0.05). The mean ± SD compared within the groups for Hb. g/dl in PTB and control showed statistical significant difference (p < 0.05). However, mean ± SD of the following groups PTB and PTB + HIV, HIV seropositive and control compared applying post Hock, showed no statistical significant difference (p > 0.05). The mean ± SD compared within the groups applying post Hock for PCV l/l showed significant statistical difference (p < 0.05) between PTB and control, HIV seropositive and control, PTB + HIV and control. However, the mean ± SD post Hock comparison between PTB and PTB + HIV, HIV seropositive and PTB + HIV and PTB and PTB + HIV respectively, showed no significant statistical difference (p > 0.05). Also, the mean ± SD post Hock comparison of WBC x 109 g/dl showed that PTB and HIV, PTB and normal control and HIV seropositive and normal control were statistically significant (p < 0.05). The statistical comparison between PTB and PTB + HIV, HIV seropositive and PTB + HI, then PTB + HIV and normal control groups in WBC x 109 g/dl show statistically no significant difference (p > 0.05). The mean ± SD neutrophil % compared between the following: PTB and HIV, PTB and PTB + HIV, HIV seropositive and normal control then PTB + HIV and normal control were in each case, not significantly different (p > 0.05). Also, the mean ± SD neutrophil % compared by post Hock analysis between PTB and normal control showed statistical significant difference (p < 0.05).
  • 3. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 3 The mean ± SD Lymphocyte % compared between PTB and HIV, PTB and PTB + HIV, HIV seropositive and PTB + HIV, HIV seropositive and control, then PTB + HIV and control show no significant difference (p > 0.05). However, mean ± SD comparison of lymphocyte % between PTB and normal control show statistical significant difference (p < 0.05). Mean ± SD lymphocyte % comparison within all the groups: PTB and HIV seropositive, PTB and PTB + HIV, PTB and normal control HIV seropositive and PTB + HIV, HIV seropositive and normal control showed no significant difference (p > 0.05 in each case). (See table 1). The mean ± SD platelet count (X109 g/dl ) values in PTB (223, 166.67 ± 56, 056 – 39), HIV seropositive (179,666.67 ± 39831.381), PTB + HIV (191,000.00 ± 63,493.53) and control (178, 545.45 ± 34, 617.26), were compared using ANOVA and showed significant mean difference (F = 4.81, p < 0.05). The mean ± SD comparison of platelets between PTB and HIV seropositives, showed higher significant value in PTB (p<0.05). Also the mean ±SD platelets count showed higher significant value in PTB compared with the controls (p<0.05). However, the mean ± SD platelet count compared between PTB and PTB + HIV, HIV seropositive and PTB + HIV also between HIV seropositive and control and PTB + HIV and control showed no significant difference in values (p > 0,05) in each case. The mean ± SD ESR mm/hr values in PTB (75.54 ± 36.71), HIV seropositive (46.89 ± 41.65); PTB + HIV (112.75 ± 32.07), and control subjects (11.18 ± 9.75) compared using ANOVA presented statistically significant difference (F = 24, 13; p < 0.05). Mean ± SD comparison of values in ESR using tests showed that PTB, HIV seropositve and PTB + HIV, ESR mm/hr values were significantly higher than the values of ESR mm/hr in the control subjects (p < 0.05) in each case. Also, PTB compared with HIV seropositive ESR mm/hr values showed higher significant difference (p < 0.05). Also the comparison of the PTB + HIV compared with PTB showed statistically significant difference (p < 0.05). The mean ±SD for MCHC values in PTB (32.64 ± 1.90), HIV seropositives (32.84 ± 1.26), PTB + HIV (33.16 ± 1.95) and control (33.40 ± 1.32) compared showed no significant difference (F = 2.03; p = 0.11). Moreover, further inter - comparison of values in parameter (MCHC) in PTB and HIV seropositive PTB and PTB + HIV, PTB and control showed similar mean values ( p > 0.05) in each case. Table 2, Compared the mean ± SD, Haematological changes in different groups PTB, HIV seropositive, PTB + HIV and normal control, between male and female (in each case) using student’s t test. The mean ± SD Hb g/dl in PTB compared between male (11.76 ± 1.95) and female (11.06 ± 1.60) showed no statistical significant difference (p > 0.05). Also, mean ± SD PCV l/l compared between male (0.35 ± .07) and female (0.34 ± 0.04) showed no significant difference (p > 0.05). Mean ± SD WBC x 109 /l. ESR mm/hr, in PTB compared between male (6.25 ± 1.39, 87.67 ± 40.13) respectively and female (4.76 ± 1.06; 64.70 ± 31.00) respectively were both not significantly different in values (p > 0.05). Moreover, the mean ± SD neutrophil % and lymphocyte % in PTB male and female patients compared showed no statistical significant difference (p > 0.05 in each case). The mean ± SD Hb g/dl; PCV l/l, platelet x 109 /l, WBC x 109 /l, ESR mm/hr, Neutrophil % and Lymphocyte %, in PTB + HIV infected males and females compared (in each case), were statistically similar in value ( p > 0.05). Also mean ± SD Hb g/dl; PCV l/l, WBC x 109 /l, ESR mm/hr, Neutrophil % and Lymphocyte % values, compared between control male and female (in each case) resulted in statistically no significant difference (p > 0.05); On the other hand, mean ± SD, platelet count x 109 /l in PTB male (225.54 ± 54.4) compared with female (125.6 ± 38.47) showed higher significant difference (p < 0.05). However, mean ± SD monocyte in PTB, compared between male (1.82 ± 1.40) and female (3.91 ± 2.43) show significantly lower difference (p < 0.05). DISCUSSION: There was a significantly lower haemoglobin level in PTB patients with and without HIV co- infection in this study. This may be due to decreased erythrocyte lifespan, impaired marrow response or impaired flow of iron (fe) from macrophages to the plasma in iron (fe) cycle metabolism. This decrease in haemoglobin may also be due to a non-immune mechanism that develops secondary to granulomatous infiltration of the bone marrow. This finding is in agreement with those of (Das et al 2003; Lawson et al 2008; Mugusi et at 2009; and Ursavas et al 2010); who suggested a mild to moderate anaemia that frequently accompanied infections, inflammatory and neoplastic diseases. The anaemia may reflect reticuloendothelia iron block by disease entity and in HIV disease; partly due to suppression of erythropoiesis by cell to cell interaction (Lemoha et al 2004; Mugasi et al 2009 and Ursavas et at, 2010). The mean ESR in PTB and PTB + HIV patients was significantly high when compared with that of control subjects. The reason may be due to alterations in the plasma proteins as may be the case in different entities (Ursavas et al, 2010). Since the erythrocyte sedimentation rate is a non-specific reaction which may be compared with the body temperature, pulse rate and the leukocyte count, it is a measure of the inflammatory response or reaction in a disease entity.
  • 4. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 4 Hence an accelerated erythrocyte sedimentation rate (ESR) is seen in patients with PTB and PTB + HIV and HIV seropositive patients when compared with control. So an accelerated erythrocyte sedimentation rate (ESR) may serve as a guide to the progress of disease that has already been recognized and this being particularly true in regard to pulmonary tuberculosis (Bozoky et al, 1999 and Ursavas et al, 2010). The total white blood cell count (WBC) of patients with PTB + HIV and PTB were significantly higher than those of the control subjects in this study. The reason for these alterations in the blood leukocyte concentration which in this case was due to neutrophilia is an indication of recurrent continuous inflammatory response. This will usually change to lymphocytosis during chronic inflammatory response, the patients used for this study were those with active tuberculosis and the findings were in agreement with those of (Jadoon et al 2004 and Ursavas et al, 2000). The total WBC in patients with HIV seropositive in this study showed mild leucopenia. This observed difference, might be due to the causative agent, HIV, a lentivirus, when compared with that of PTB, caused by Mycobacterium tuberculosis. Another reason, for the leucopenia in HIV infection might be due to decrease bone marrow production of granulocyte progenitor cells (CFUGM), colony forming unit granulocyte – monocyte from the bone marrow of patients with HIV infection (Costello et al, 1999). The result also showed a significant increase in monocyte count in patients with PTB and PTB + HIV. The monocyte, a known phagocytic cell is expected to be increased in active tuberculosis infection. Hence, this finding is in agreement with of previous authors (Bozoky et al, 1997). There was no significant difference in lymphocyte count of patients with PTB and PTB + HIV, when compared in each case with control. This is not in agreement with previous report by Bozoky et al, (1997) who reported mild lymphocytosis in PTB with or without HIV co-infection. The location where this study was done may have contributed to this different observation. The MCHC result in this study showed low normal results; hence there is no significant difference between the PTB, HIV seropositive and PTB + HIV with the normal control results. Although, anaemia is recorded for the patients but the type is anaemia of chronic disorder, hence, normocytic – normochronic. This is in agreement with previous report of Treacy et al (1984); who reported a mild anaemia in HIV/AIDS patients. It does not agree with the report of severe anaemia with erythroid hypoplasia in HIV patients with disseminated mycobacterium avium intracellular (MAI) infection (Gardener et al 1987). The platelets result in this study, showed significant difference between the groups. The count in PTB is significantly higher than those of HIV seropositive, normal control and PTB + HIV. The mean ± SD platelet count showed no significant difference in values between PTB + HIV, HIV seropositive and control groups. This is in agreement with previous report by Pust et al 1974, which showed there was mild thrombocytosis in tuberculosis. The result is also in agreement with previous report by Costello et al (1999) which showed there is mild thrombocytopenia in male and female patients with HIV. Some authors have reported presence of auto- antibody complexes as being responsible for the mild decreased platelet count in HIV infection (Mugusi et al, 2009). The Haematologic changes in PTB + HIV, PTB and HIV seropositive patients showed varied pictures due to the stage of the infection and the causative agents. Mycobacterium tuberculosis and Human Immune deficiency virus. REFERENCES: Bozoky G, Rubye; Gher I, Toth J, Mohos A. (1997), “Haematologic Abnormalities in pulmonary tuberculosis”. ORV. Hetil. 138 (17): 1053 -1056. Chang S.L, Wang H.C, Yang P.C (2007), “Paradoxical response during anti-tuberculosis treatment in HIV negative patients with pulmonary tuberculosis”. Int. J. Tuberc. Lung Dis. (11)12: 1290 – 1295. Connoly C, Reid A; Davies G, Strum W, MC Adam K.P, Wilkinson D. (1999), “Relapse and mortality among HIV – infected and uninfected patients with tuberculosis successfully treated with twice weekly directly observed therapy in rural South Africa”. AIDS. 13: 1543 – 1547. Costello (1999), “The haematological manifestation of HIV disease in Hoffbrand” A-V, Lewis S.M. Tuddeham EGD editors. Post-graduate haematology. 4th ed. Oxford. England Butterworth, Das B.S, Devi U, Mohan Raoc, Srivastard VK, Heinmann Rath PK, (2003), “Effect of Iron supplement on mild to moderate anaemia in pulmonary tuberculosis”. Br.J. Nutrition; 90(3) 541-550. Das B.S, Dev. U, Mohan R.O.C, Srivastava V.K, Rath P.K (2003), “Effect of Iron Supplementation on mild to moderate anaemia in pulmonary tuberculosis”. B. J. Nutrition. 90(3): 541-550. Dacie and Lewis (1984), “Practical haematology”, 6th Edition, Medical Division of Longman Group Ltd. pp. 470-474. Jadoon S.M, Moir S, Ahmed T.A, Bashir MM (2004), “Smear negative pulmonary tuberculosis and lymphocyte subsets”. J. Coll. Physicians Surg. Pak. 14(17): 419-422.
  • 5. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 5 Jemikalajah D.J. and Okongwu G.R.A. (2009), “Health point prevalence of Human Immunodeficiency Virus and Pulmonary Tuberculosis among patients in various parts of Delta State, Nigeria”. Saudi Med. J. 30: 387 – 391. Kassu A, Tsgaye A, Petros B. (2001), “Distribution of Lymphocyte subsets in healthy human immunodeficiency virus- negative adult Ethiopians from to geographic locales”. Clin. Diagn. Lab. Immunol. 8: 1171-1176. Lawson L, Yassin M.A, Thather TD, Olatunyji O.O, Akingbogun I, Bellow G.S, Cuevas L.E, Davies P.D. (2008), “Clinical presentation of adults with pulmonary tuberculosis with and without HIV co-infection in Nigeria”. Scand J. Infect. Dis. 40 (1): 30-35. Lemoha E., Audu R.A., Akanmu A.S. (2004), “Evaluation of Correlation between CD4 cell count and haemoglobin in HIV-infected patients in Lagos”. Abstract presented at the 4th National Conference on HIV/AIDS. International Conference Centre, Abuja, Nigeria. Mugusi MF, Mehta S, Villamor E, Urassa W, Saathoff E, Bosch RJ, and Fawzi W (2009), “Factors associated with mortality in HIV infection and uninfected patients with pulmonary tuberculosis”. B M C Public Health Journal 12: 409 Putong N, Pitisuttithum P, Spanaranondilihp. Tansuphasawa D.S and Silachromroon U (2002), “Mycobacterium tuberculosis infection among HIV/AIDS patients in Thailand: clinical manifestation and out comes in South East Asia”. J. Trop. Med. Public Health 33: 346 – 350. Raviglone M.C., Narain J.P, Kochi A. (1995) “HIV Associated tuberculosis in developing countries, clinical features, diagnosis and treatment”. Bull. World Health Orgams. 70: 515-526. Treacy M. (1997), “Bone Marrow Examination in HIV infection”. J. of Haem.78: 10-12. Ursavas A, Dane E, Ridran A, Duygu K, Dilek B, Guzia K, Funda C and Ercument E. (2010), “Immune thrombocytopenia associated with pulmonary tuberculosis”. J. infect. Chemotherapy. 16: 42 – 44. Watts H.G, Lifeso R.M: (1996), “Tuberculosis of bones and joints”. Bone Joints Surg. Journal: 78: 288 – 298. World Health Organization (2008), “Global TB control, Geneva. WHO/HTM/PTB /2008: WHO declares PTB an emergency in Africa” Call for urgent and extraordinary actions to halt a worsening epidemic 340: 92 – 95. World Health Organization (2005), “Global Tuberculosis control”. WHO/HTM/ PTB/2005, Geneva, Switzerland, 349: 81 - 85.
  • 6. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 6 Table 1:HAEMATOLOGICAL CHANGES IN PTB, HIV, PTB + HIV AND NORMAL CONTROL SUBJECTS. SUBJECT Hb g/dl PCV l/l ESR mm/hr WBC x109 /l Platelet x109 /l Neut. % Lymph % Mono % MCHC 1, PTB (n=32 11.60 ± 1.96 0.35 ± 0.07 75.54 ± 36.71 6062.5 ± 1481.83 223166.67 ± 56056.39 50.63 ± 17.95 40.88 ± 19.08 3.21 ± 1.97 32.64 ± 1.90 2, HIV (n=58) 11.51 ± 2.15 0.36 ± 0.05 46.89 ± 41.65 3841.38 ± 735.58 179666.67 ± 39831.38 37.93 ± 15.54 55.28 ± 16.15 4.50 ± 2.81 32.84 ± 1.26 3, PTB+HIV (n=20) 11.27 ± 1.62 0.35 ± 0.04 112.75 ± 32.07 4422.22 ± 1851.88 191000.00 ± 63,493.53 38.89 ± 17.95 56.33 ± 17.90 3.75 ± 2.49 33.16 ± 1.95 4, Control (n=40) 13.67 ± 1.46 0.41 ± 0.05 11.18 ± 9.75 4363.64 ± 551.66 178545.45 ± 34617.26 53.41 ± 8.99 60.77 ± 8.16 3.57 ± 1.63 33.40 ± 1.32 F (p) Value 1.059 0.37 5.07 0.003 24.13 0.043 15.25 0.00 4.81 0.004 4.34 0.007 5.54 0.002 1.12 0.35 2.03 (0.11) 1 vs. 2 p Value 0.41 0.96 0.06 0.00 0.02 0.11 0.074 0.36 0.38 1vs. 3 p Value 0.97 0.99 0.07 0.15 0.60 0.42 0.22 0.95 0.91 1 vs. 4 “ 0.007 0.044 0.00 0.002 0.01 0.01 0.005 0.94 0.06 2 vs. 3 “ 0.37 0.86 0.00 0.80 1.96 1.0 1.0 0.89 0.81 2 vs. 4 “ 0.74 0.007 0.00 0.33 1.00 0.56 0.40 0.52 0.92 3 vs. 4 “ 0.009 0.017 0.00 1.0 0.95 0.82 0.89 0.97 0.36
  • 7. Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.11, 2013 7 Table 2:Haematologic Changes in Different Groups: PTB, PTB + HIV, HIV Seropositive and Normal Control compared between sexes (male and female) using student’s t tests. S/N SUBJECT Hb g/dl PCV l/l WBC x109 /l ESR mm/hr Mono % Neut % Lymph % Platelets x109 /l 1 PTB – HIV male (n=30) 11.76 ± 1.95 0.35 ± 0.07 6.25 ± 1.39 87.67 ± 40.13 1.82 ± 1.40 50.87 ± 16.66 41.40 ± 16.77 244.33±46.39 2 PTB – HIV female (n=20) 11.06 ± 1.60 0.34 ± 0.04 4.76 ± 1.06 64.70 ± 31.00 3.91 ± 2.43 39.70 ± 19.92 54.00 ± 22.39 233.55±67.16 3 PTB–HIV male/female P-value 0.97 0.99 0.09 0.74 0.03 0.82 0.79 0.69 4 PTB + HIV male (n=10) 10.36 ± 5.1 0.33 ± 0.05 5.46 ± 1.24 131.00 ± 74.20 1.67 ± 1.53 43.00 ± 21.42 51.60 ± 40.85 164.08±33.07 5 PTB + HIV female (n=6) 12.80 ± 0.53 0.37 ± 0.02 4.30 ± 0.61 60.00 ± 34.64 3.67 ± 3.06 30.67 ± 14.19 67.00 ± 12.12 184.58±42.68 6 PTB + HIV male/female 0.16 0.85 0.66 0.63 0.32 0.96 0.87 0.19 7 HIVseropositive male (n=24) 13.12 ± 1.84 0.39 ± 0.05 3.68 ± 0.60 32.92 ± 37.50 3.42 ± 2.71 33.83 ± 15.41 60.42 ± 16.78 225.40±54.5 8 HIV seropositive female (n=30) 11.24 ± 1.54 0.34 ± 0.04 4.0 ± 0.90 54.73 ± 46.44 3.83 ± 3.27 40.67 ± 16.47 51.60 ± 16.10 125.60±38.47 9 HIV male/female P.Value 0.14 0.17 0.96 0.87 0.74 0.95 0.86 0.02 10 Control male (n=22) 14.78 ± 1.05 0.43 ± 0.04 4.11 ± 0.45 7.73 ± 5.62 2.64 ± 1.69 33.27 ± 7.76 61.00 ± 4.45 169.09±36.61 11 Control female (n=18) 12.56 ± .83 0.38 ± .o4 4.54 ± .04 14.64 ± 11.91 4.18 ± 1.54 33.54 ± 10.49 60.55 ± 10.95 188.00±31.30 12 Control male / female P Value 0.001 0.06 .71 .67 0.08 1.00 1.00 0.16
  • 8. This academic article was published by The International Institute for Science, Technology and Education (IISTE). The IISTE is a pioneer in the Open Access Publishing service based in the U.S. and Europe. The aim of the institute is Accelerating Global Knowledge Sharing. More information about the publisher can be found in the IISTE’s homepage: http://www.iiste.org CALL FOR JOURNAL PAPERS The IISTE is currently hosting more than 30 peer-reviewed academic journals and collaborating with academic institutions around the world. There’s no deadline for submission. Prospective authors of IISTE journals can find the submission instruction on the following page: http://www.iiste.org/journals/ The IISTE editorial team promises to the review and publish all the qualified submissions in a fast manner. All the journals articles are available online to the readers all over the world without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. Printed version of the journals is also available upon request of readers and authors. MORE RESOURCES Book publication information: http://www.iiste.org/book/ Recent conferences: http://www.iiste.org/conference/ IISTE Knowledge Sharing Partners EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open Archives Harvester, Bielefeld Academic Search Engine, Elektronische Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial Library , NewJour, Google Scholar