This document outlines a dissertation protocol that aims to evaluate the role of reticulocyte indices in assessing the cause of pancytopenia. The study will analyze reticulocyte percentage, immature reticulocyte fraction, and mean reticulocyte volume in 100 pancytopenia patients over 18 months. These indices will be correlated with clinical and laboratory findings to categorize the etiology and formulate a diagnostic algorithm. Obtaining informed consent and maintaining confidentiality addresses ethical aspects of the study.
It is also called as complete blood picture/complete blood count(CBP/CBC)
The FBC assesses several different parameters and can provide a great deal of information.
The red cell variables will determine whether or not the patient is anaemic. If anaemia is present the MCV is likely to provide clues as to the cause of the anaemia.
The white cells are often raised in infection neutrophilia in bacterial infections and lymphocytosis in viral (but not always so).
Platelets (size or number) may be abnormal either as a direct effect of underlying blood disease.
It is also called as complete blood picture/complete blood count(CBP/CBC)
The FBC assesses several different parameters and can provide a great deal of information.
The red cell variables will determine whether or not the patient is anaemic. If anaemia is present the MCV is likely to provide clues as to the cause of the anaemia.
The white cells are often raised in infection neutrophilia in bacterial infections and lymphocytosis in viral (but not always so).
Platelets (size or number) may be abnormal either as a direct effect of underlying blood disease.
Sickle Cell Disease (SCD) is major health problem in
Tanzania. Every year, approximately 11000 babies are born
with SCD1, and this number is expected to double by the year
2050. Tanzania has the fourth greatest number of annual
SCD births in all of Africa, and the fifth greatest in the world.
In addition, almost 20% of the Tanzanian population carries a
copy of the sickle gene in a form of sickle cell trait (AS).
Despite these staggering statistics, Tanzania has made
progress in the fight against SCD over the past decade. In
2008, the Ministry of Health and Social Welfare by then,
recognized SCD as a priority disease in the National strategy
for Non-communicable disease 2009- 2015, calling for all
sector to cooperate in combating the disease. A chapter on
SCD was also included in the national Non-communicable
Disease Treatment Manual.
Hydroxyurea is useful in the management of individuals with SCD. It reduces the complications
of SCD in infants, children and adults based on its ability to:
o Increase haemoglobin F levels
o Increase steady state hemoglobin counts
o Lower WBC and PLTs hence moderate the chronic inflammation state in SCD
Indications for starting hydroxyurea:
All children 9 months and above with proven SCD
Adolescents and adults with the following:
o Recurrent VOC ( 3 or more severe episodes requiring admission in the last 12
months)
o Severe and/or recurrent ACS (2 or more episodes in a lifetime)
o History of stroke or abnormal TCD (≥199cm/sec)
o Severe symptomatic chronic anemia that interferes with daily activities or quality of
life
o To reduce the risk of new or recurrent stroke where chronic transfusion therapy is not
feasible.
o Recurrent priapism
o Patient with chronic kidney disease on erythropoietin to improve anemia
#SickleCell disease#Indications for Hydroxyurea#Hamisi Mkindi#CKD#Investigations:
FBP - absolute neutrophil count (ANC) > 1,500/µl, platelet > 100,000/ul, Hb> 6g/dl.
If Hb is less than 6gm/dl do Reticulocyte Count[Do not start hydroxyurea in patients with
Hgb< 6 g/dl AND absolute reticulocyte count (ARC)<100,000/µL]
Serum Creatinine - should be within normal range,
Serum ALT – should not be greater than twice the upper limit of normal,
Bilirubin Total and direct
Urine Pregnancy Test in women
HPLC - Quantification of HbF (if this test cannot be done, Hydroxyurea should be prescribed
nevertheless and an elevated baseline HbF should not affect the decision to initiate
hydroxyurea)
Why there is a need of film review in iso compliant hema labs in this days of...honorinamagnonuguid
Blood Slide Morphology is very much needed to affirm the Flags of Each Cell Histograms, nothing beats the human eyes to assess the unstromatolyzed morphology, nucleolar structures, NC ratio /etc inherent to particular cell in question... EDTA platelet sattelitism, even on those days of early 80's , we usually read the blood films of the presence of even filarial worms, malarial gametocytes/ring forms...cytoplasmic granules even, once I had seen that lysosomal granules in the leukocytes, it was a very challenging job before the advent of the latest VCS / Cytoflowmetry...I think a very well trained morphologist have an edge in handling bothwise, wont you agree? So lets not forget the efficacy of our H and E polychromatophiles...God Bless our hematology labs, bring out the best in our skills to detect and identify for the betterment of the health consumers.
Sickle Cell Disease (SCD) is major health problem in
Tanzania. Every year, approximately 11000 babies are born
with SCD1, and this number is expected to double by the year
2050. Tanzania has the fourth greatest number of annual
SCD births in all of Africa, and the fifth greatest in the world.
In addition, almost 20% of the Tanzanian population carries a
copy of the sickle gene in a form of sickle cell trait (AS).
Despite these staggering statistics, Tanzania has made
progress in the fight against SCD over the past decade. In
2008, the Ministry of Health and Social Welfare by then,
recognized SCD as a priority disease in the National strategy
for Non-communicable disease 2009- 2015, calling for all
sector to cooperate in combating the disease. A chapter on
SCD was also included in the national Non-communicable
Disease Treatment Manual.
Hydroxyurea is useful in the management of individuals with SCD. It reduces the complications
of SCD in infants, children and adults based on its ability to:
o Increase haemoglobin F levels
o Increase steady state hemoglobin counts
o Lower WBC and PLTs hence moderate the chronic inflammation state in SCD
Indications for starting hydroxyurea:
All children 9 months and above with proven SCD
Adolescents and adults with the following:
o Recurrent VOC ( 3 or more severe episodes requiring admission in the last 12
months)
o Severe and/or recurrent ACS (2 or more episodes in a lifetime)
o History of stroke or abnormal TCD (≥199cm/sec)
o Severe symptomatic chronic anemia that interferes with daily activities or quality of
life
o To reduce the risk of new or recurrent stroke where chronic transfusion therapy is not
feasible.
o Recurrent priapism
o Patient with chronic kidney disease on erythropoietin to improve anemia
#SickleCell disease#Indications for Hydroxyurea#Hamisi Mkindi#CKD#Investigations:
FBP - absolute neutrophil count (ANC) > 1,500/µl, platelet > 100,000/ul, Hb> 6g/dl.
If Hb is less than 6gm/dl do Reticulocyte Count[Do not start hydroxyurea in patients with
Hgb< 6 g/dl AND absolute reticulocyte count (ARC)<100,000/µL]
Serum Creatinine - should be within normal range,
Serum ALT – should not be greater than twice the upper limit of normal,
Bilirubin Total and direct
Urine Pregnancy Test in women
HPLC - Quantification of HbF (if this test cannot be done, Hydroxyurea should be prescribed
nevertheless and an elevated baseline HbF should not affect the decision to initiate
hydroxyurea)
Why there is a need of film review in iso compliant hema labs in this days of...honorinamagnonuguid
Blood Slide Morphology is very much needed to affirm the Flags of Each Cell Histograms, nothing beats the human eyes to assess the unstromatolyzed morphology, nucleolar structures, NC ratio /etc inherent to particular cell in question... EDTA platelet sattelitism, even on those days of early 80's , we usually read the blood films of the presence of even filarial worms, malarial gametocytes/ring forms...cytoplasmic granules even, once I had seen that lysosomal granules in the leukocytes, it was a very challenging job before the advent of the latest VCS / Cytoflowmetry...I think a very well trained morphologist have an edge in handling bothwise, wont you agree? So lets not forget the efficacy of our H and E polychromatophiles...God Bless our hematology labs, bring out the best in our skills to detect and identify for the betterment of the health consumers.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
What are greenhouse gasses how they affect the earth and its environment what is the future of the environment and earth how the weather and the climate effects.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
2. ROLE OF RETICULOCYTE INDICES
IN EVALUATION OF
PANCYTOPENIA
DR.MIDHAT AEJAZ
DISSERTATION FOR THE COURSE OF MD PATHOLOGY
GUIDE: DR. S R NIVEDITHA
PROFESSOR,DEPARTMENT OF PATHOLOGY
KEMPEGOWDA INSTITUTE OF MEDICAL SCIENCES,BANGALORE
3. INTRODUCTION
• Pancytopenia is a term used for the reduction in the count of red
blood cells,white blood cells and platelets.
• Identifying the underlying cause is challenging as there are wide
range of etiologies ( infections, drugs ,autoimmune,
hemophagocytosis and inherited conditions).
• The reticulocyte indices given by the automated cell counters are
found to help in assessing the bone marrow activity, thereby
categorising the various causes.
4. NEED FOR STUDY
• Pancytopenia - involves a wide number of causes primarily or
secondarily involving the bone marrow.
• Cornerstone for evaluation of pancytopenia is Bone marrow study
(BMA & BMBx)
• However, Reticulocyte indices generated by advance coulters can aid
in identifying the cause of pancytopenia in least invasive fashion.
• Also an algorithmic approach of various clinical,routine
hematologiical and reticulocyte indices can help in early diagnosis
and management of pancytopenia.
5. AIM AND OBJECTIVES
• Recording reticulocyte indices( Reticulocyte percentage, Immature
reticulocyte fraction,Mean reticulocyte volume) in pancytopenia.
• Correlation of the reticulocyte indices with the etiological factors of
pancytopenia.
• Formulate a diagnostic algorithm to categorise pancytopenia effectively.
6. SUBJECT OR MATERIAL
• STUDY DURATION- 18 months
• STUDY DESIGN- Cross sectional study
• SAMPLE SIZE-100
• SAMPLING METHOD-Purposive
• INCLUSION CRITERIA-
Samples with Hb<13.5g/dl in males ans<11.5g/dl in females,
Total leucocyte count<4000/cumm
Platelet count<1.5lakh/cumm
• EXCLUSION CRITERIA-
Hemolysed samples
Detailed clinical history not available
Patient who have received recent blood transfusion(<3 weeks)
7. METHODS AND PROCEDURES
• The study will be conducted in central laboratory ,Department of
pathology.
• Hundred cases of pancytopenia (irrespective of age and gender) will
be the study group after obtaining consent.
• The reticulocyte indices generated by SYSMEX XN-1000 auto
analyser will be noted .
• Relevant clinical details , biochemical investigations will be
documented and correlated with the reticulocyte indices.
