Showing 569 results for Research Article: Original Paper
Abazar Yari , Morteza Ahmadi , Mahdieh Mehrpouri ,
Volume 18, Issue 5 (9-2024)
Abstract
Background: Thyroid hormones play a critical role in hematopoiesis, and thyroid disorders such as hypothyroidism and hyperthyroidism can affect blood parameters. Therefore, this study aimed to evaluate the effect of thyroid dysfunction on various blood parameters.
Methods: This case-control study included 194 subjects who were classified into three groups based on TSH levels: hypothyroid (n=70), hyperthyroid (n=56), and control (n=68). Conditions that affect blood parameters, including pregnancy, inherited or acquired red blood cell abnormalities, chronic inflammatory diseases, evidence of nutritional deficiencies, and underlying diseases such as cancer, as well as patients unwilling to participate in the study, were excluded. Hematological parameters were measured using a cell counter, and the results were analyzed using SPSS software.
Results: The results showed that 78% of the participants were female and 22% were male, aged 4 to 89 years. The analyses revealed that RBC, Hb, HCT, WBC count, and WBC differential count were significantly different between the three groups (P-value <0.05), but the differences were not significant for MCV, MCH, MCHC, RDW, PLT, and MPV (P-value >0.05). Correlation analysis indicated a significant correlation between TSH and Hb, HCT, WBC, PLT, neutrophils, lymphocytes, monocytes, and eosinophils (P<0.05).
Conclusion: Since thyroid hormones play a critical role in hematopoiesis, thyroid dysfunction can affect many hematological parameters. Therefore, the management of patients with thyroid disease should include the CBC test. In addition, patients with poor responses to anemia treatment may have an underlying thyroid disorder.
Usunobun Usunomena, Ambrose Emuobonuvie Akpovona ,
Volume 18, Issue 5 (9-2024)
Abstract
Background: Telfairia occidentalis is among the most popular vegetable crops propagated in the West African rainforest zone for its green leafy vegetable and ellipsoidal fruit, which are highly nutritious. This study investigated the liver's synthetic ability and hematological profile potential of T. occidentalis against carbon tetrachloride-induced toxicity in Wistar rats.
Methods: Five experimental groups of rats were used in this study. One group received distilled water and served as the normal control. The second group received carbon tetrachloride (CCl4) alone for four days. The third and fourth groups received CCl4 for four days prior to treatment with 200 mg/kg and 400 mg/kg T. occidentalis aqueous extract for six days, respectively. The last group received CCl4 for four days prior to treatment with silymarin (100 mg/kg) for six days. With the exception of normal control rats, all rats received a mixture of freshly prepared CCl4 in olive oil (1 ml/kg, 1:1 intraperitoneally) for four days. The activities of liver synthetic molecules, such as total protein, albumin, and total bilirubin, as well as hematological parameters, were measured in the blood.
Results: CCl4 exposure and toxicity caused a significant (P < 0.05) increase in total bilirubin and white blood cells and a significant decrease in total protein, albumin, hemoglobin, hematocrit, red blood cells, and platelets. However, treatment with T. occidentalis aqueous extract significantly (P < 0.05) ameliorated the levels of these markers toward normal values.
Conclusion: T. occidentalis aqueous extract exhibited enhancement of liver synthetic ability and hematological profile in CCl4-induced toxicity.
Aradhana Harrison , Aswathy Prabha , Karishma Krishna , Vejay Viknesh Marudhadurai , Jahnavi Chikkegowda, Rajshree Choudhary ,
Volume 18, Issue 5 (9-2024)
Abstract
Background: β-thalassemia trait (BTT) can be screened by several discriminator indices (DIs) using complete blood counts (CBC). These DIs can help differentiate BTT from other causes of anaemia, thus reducing the financial burden of laboratory testing. At standard cut-off values, statistical analyses traditionally used to compare the diagnostic competence of these DIs give variable results. This study establishes new optimal cut-off values to improve the applicability of these DIs for BTT screening.
Methods: This was a retrospective study conducted on anaemic adults whose high-performance liquid chromatography (HPLC) and CBC results achieved over the past 6 months were reviewed. Based on HPLC reports, patients were categorised into BTT and non-BTT groups, with each group comprising 25 age- and sex-matched patients. Discriminator indices, including Mentzer’s Index (MI), Green and King Index (GKI), Sehgal Index (SI), Shine and Lal Index (SLI), Srivastava Index (SrI), and England and Fraser Index (EFI), were calculated for both groups. Statistical analysis was performed respective to standard cut-off values to establish new optimal cut-off values with the highest sensitivity and specificity.
Results: According to the results, SrI emerged as the best index, offering high sensitivity, specificity, Youden’s Index, accuracy, and odds ratio. On the other side, SLI and GKI were observed to be poor indices with low sensitivity and specificity. The new optimal cut-off values for the best performance of each DI for BTT screening were as follows: SrI ≤3.5, MI ≤11.4, GKI ≤59.7, SI ≤709.4, SLI ≤941.1, and EFI ≤1.91.
Conclusion: The performance of DIs at standard cut-off values was poor to screen BTT. New optimal cut-off values provided maximal sensitivity and specificity thereby enhancing their performance as screening parameters for BTT in regions with a high-prevalence of the condition. Further studies are warranted to substantiate the new cut-off values for BTT screening.
Bizav Rasheed , Beri Tawfeq,
Volume 18, Issue 6 (11-2024)
Abstract
Background: Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. The disease may also affect other parts of the body, including the skin, eyes, lungs, heart, nerves, and blood. This study aimed to evaluate the effect of methotrexate on blood, liver, and renal parameters in patients with RA.
Methods: A six-month cross-sectional study was carried out on 60 consecutive patients aged 19-70 years diagnosed with RA on methotrexate treatment (10 mg) orally per week. A questionnaire was taken from participants, and laboratory tests were done on renal and liver function and complete blood count (CBC), erythrocyte sedimentation rate (ESR), glutamic oxaloacetic transaminase (SGOT or AST), glutamate pyruvate transaminase (SGPT or ALT), Creatinine, C-reactive protein (CRP), and rheumatoid factor (RF) as a follow-up to drug intake.
Results: At the end of sample collection, participants ranged in age from 19 to 70 years, with a female-to-male ratio of 1.5:1. Significant differences in platelet (PLT) levels were observed only between days 1 and 14 of the treatment (p <0.05). Similarly, SGPT levels showed significant variation between days 1 and 30 of the treatment (p <0.05). Additionally, RF levels exhibited significant differences between days 1 and 14 (p <0.01) and between days 1 and 30 of the treatment (p <0.04).
Conclusion: The recommended medication for all kinds of patients with RA is methotrexate, which has had a notable impact on blood, liver, and kidney parameters. These characteristics can serve as indicators for monitoring the medication’s effectiveness, safety, and patient follow-up.
Joseph Ki , Mohan Kumar , Kanagasabapathy Sivagami , Jeevithan Shanmugam , Periasamy Aparnavi ,
Volume 18, Issue 6 (11-2024)
Abstract
Background: The ABO and Rh blood group systems have been associated with variations in disease susceptibility. This study aimed to assess the variability in blood parameters, including red cell parameters and metabolic parameters (Renal function, hepatic function, blood glucose, lipid profile, and thyroid function), by ABO and Rh blood grouping systems.
Methods: A secondary data analysis was conducted among patients who underwent a preventive health check-up at a private tertiary care hospital in Coimbatore, India. The laboratory database contained records of 62,808 adult participants who reported for master health check-ups between January 2017 and February 2024. Among these patients, those who reported for the first time were included.
Results: Blood grouping and typing data were available for 50,368 and 56,155 participants, respectively, with a mean age range of 52.6 to 53.0 years across all blood groups. The most prevalent blood group was O, followed by B, A, and AB, with a similar distribution across genders. The mean hemoglobin level was highest in the B group (13.7 ± 13.9 g/dl). MCH and MCV values were elevated in the A and O groups, while MCHC and ESR were higher in the B and AB groups. Renal and liver parameters mostly did not vary by blood group or Rh type, except for elevated urea levels in the A group and higher ALP levels in the O and Rh-positive groups. LDL and total cholesterol were highest in the A group, while HDL was highest in the AB group.
Conclusion: The results underscore the importance of considering blood group variations when interpreting blood parameters in clinical practice.
Zahra Eslami , Shayan Marhamaty, Seyyed Mehdi Jafari , Mohadese Khorasani , Mehdi Sheikh Arabi , Hamidreza Joshaghani ,
Volume 19, Issue 1 (1-2025)
Abstract
Background: Bivalent minerals function as crucial cofactors that participate in a multitude of metabolic pathways within the organism. Specifically, zinc (Zn) assumes catalytic, structural, and regulatory roles in numerous biological processes. A severe deficiency in Zn can lead to disruptions in nucleic acid and protein synthesis, impaired cellular proliferation, increased apoptosis, and heightened lipid peroxidation of cellular membranes, a phenomenon associated with a reduced lifespan of red blood cells (RBCs). The objective of this study was to investigate the correlations between Zn status and various erythrocyte indices in a cohort of anemic patients, in comparison to a control group.
Methods: A cohort of 563 participants was enrolled in this investigation. Serum Zn concentration was quantified using a BT-3500 autoanalyzer, while hematological indices were determined via a Sysmex KX21N cell counter. Following confirmation of data normality, Spearman's rank correlation coefficient was employed to analyze the relationship between serum Zn levels and RBC indices.
Results: The mean serum Zn concentration was 102.8 ± 17.6 mg/dL. Serum Zn levels exhibited a weak correlation with RBC and hemoglobin (Hb) concentrations in healthy women, as well as a weak correlation with mean corpuscular hemoglobin concentration (MCHC) in anemic men (p < 0.05). Furthermore, the results indicated significantly higher serum Zn levels, RBC, Hb, hematocrite (HCT), and MCHC in men (p < 0.01), while mean corpuscular volume (MCV) was significantly higher in women (p < 0.01). Notably, in individuals with serum Zn levels < 30 mg/dL, MCHC (p < 0.01) and RBC (p < 0.05) were elevated, whereas Hb (p < 0.05), HCT, MCV, and MCH (p < 0.01) were higher than 30.
Conclusion: Considering the potential impact of varying Zn concentrations on erythrocyte indices, including Hb and MCHC, in both healthy and anemic individuals, careful regulation of its dosage is warranted.
Sae Pol, Pooja Shah, Vaishali Gaikwad, Sujata Dharmshale, Mansi Rajmane, Rajesh Karyakarte,
Volume 19, Issue 1 (1-2025)
Abstract
Background: Tuberculosis (TB) is a disease of the respiratory system that spreads when a patient coughs, sneezes, or spits. COVID-19, another respiratory disease, created havoc in 2020 and 2021. During this pandemic, the whole healthcare system was diverted into COVID-19 patient care. It is important to determine what the status of TB was during the COVID-19 period. This study was mainly undertaken to detect the occurrence of Mycobacterium tuberculosis (M. tuberculosis) and rifampicin resistance before, during, and after COVID-19 restrictions were fully released.
Methods: Pulmonary and extrapulmonary samples from 1st January 2018 till 31st December 2022 were included in the present retrospective study. The period was divided as- 2018, 2019 - Before COVID-19 2020, 2021 -COVID-19 period with restrictions (Such as use of masks, social distancing, avoiding gatherings) 2022 -COVID-19 period without restrictions. All samples received in TB section were subjected to Cartridge-Based Nucleic Acid Amplification Test (CBNAAT). The samples were processed according to the manufacturer’s guidelines.
Results: There was no significant difference in samples received per year from 2018 to 2022. The positivity of M. tuberculosis decreased from 22.52% in the pre-COVID-19 period to 15.70% in the COVID-19 period with restrictions and increased again in 2022 (16.80%). Rifampicin resistance decreased from 10.40% to 6.89% in the COVID-19 period with restrictions. A decrease in positivity was not observed in extrapulmonary TB cases.
Conclusion: In the present study, total samples for TB received over five years were relatively the same. Restrictions imposed during the COVID-19 period could decrease TB and rifampicin resistance. Thus, imposing restrictions on TB-suspected and positive patients regularly can help prevent the spread of the disease.
Mohit Kumar , Jayaprakash C S , Athira K P,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Non-Hodgkin lymphoma (NHL) represents a heterogeneous group of lymphoproliferative malignancies with unique presentation and treatment response. This study was intended to assess the histomorphology of non-Hodgkin lymphoma subtypes and correlate with clinicopathological and immunohistochemical findings.
Methods: This retrospective study was conducted on all specimens diagnosed as NHL by histopathological analysis, with immunohistochemical correlation in the pathology department, for two years. Clinical details such as age, gender, site of the lesion, and Nodal / extranodal presentation were recorded. Histopathological analysis was performed, and Immunohistochemical (IHC) reports were obtained. Further histopathological findings were correlated with IHC results. Statistical analysis was done based on the frequency distribution.
Results: This study includes 48 cases. Most cases are 61 to 70 years old, with a male predominance (56.25 %). The most common clinical diagnosis was lymphoma (79.17 %). Most of the lesions were of lymph nodal origin (60.42 %). The cervical group (35.42 %) is the most common lymph node affected, followed by the axillary nodes. The most common extranodal sites are the retroperitoneum and stomach. On histopathological evaluation, the most common diagnosis was NHL (68.75 %) without further subtyping. Among cases where subtyping was done, the most common lesion were follicular lymphoma and diffuse large B-cell lymphoma (DLBCL). On IHC evaluation, B cell neoplasms (85.42%) were common compared to T cell neoplasms (14.58 %). The most common subtype was DLBCL (52.08 %), followed by follicular lymphoma (16.67 %).
Conclusion: Our study found diffuse large B cell lymphoma (DLBCL) as the most common type of Non-Hodgkin’s Lymphoma. Cervical lymph nodes were found to be the most common site of involvement. But the involvement of rare sites like the testis and palate was also found. Hence the probability of NHL in these rare sites should always be considered.
Kavitha Paul Konikkara, Aiswarya Mukundan , Reena John ,
Volume 19, Issue 2 (3-2025)
Abstract
Background: The surge of COVID-19 has weighed heavily on health-care systems and hospitals. Health-care workers are at high risk of exposure both in the community and workplace when providing care to patients. Quantitative assays to detect antibodies against SARS COV-2 help to determine individual antibody titer and in longitudinal monitoring of antibody response. The present study was undertaken as there is not much data available regarding the presence of SARS COV-2 antibodies among health care workers in Kerala. The objective was to estimate the IgG antibody response and to find out the associated factors in vaccinated health-care workers.
Methods: A cross-sectional study was conducted among 187 vaccinated health- care workers. The blood sample was collected from health care workers and quantitative determination of humoral antibodies (Including IgG) was done by Chemiluminescence immunoassay. The antibody response was correlated with various factors. Analysis was done using the software IBM SPSS Version 25.
Results: The seroconversion rate following the Covishield vaccine was found to be 99.47% with mean, median, and standard deviation of antibody titer being 1291.0, 311.40 and 1792.500, respectively. Statistical significance in antibody titer was observed among different categories of health care workers and in those with previous COVID-19 infection. Higher titer was noted within 3 months of vaccination and thereafter waning of titer was seen which was also statistically significant.
Conclusion: No correlation was observed with age, gender, co-morbidities, area of work and Body Mass Index (BMI). Vaccination plays a major role in containing the infection. The immune response among vaccinated health-care workers was satisfactory.
Saif Karim, Mahdi Zahedi , Zeinab Mohammadi , Nahid Poursharifi , Mehdi Khorami , Mohsen Tatar ,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Smoking is recognized as a significant risk factor for cardiovascular diseases (CVD), yet its influence on blood levels of homocysteine, folic acid, and vitamin B12 is not well understood. This study aimed to explore how smoking affects these biochemical markers in patients with CVD.
Methods: The study included 88 participants diagnosed with CVD, who were categorized into smokers (n=44) and non-smokers (n=44). Serum concentrations of homocysteine, folic acid, and vitamin B12 were assessed using ELISA. Additionally, blood pressure (both systolic and diastolic) and body mass index (BMI) were recorded.
Results: Smokers showed significantly lower levels of folic acid (22.41 ± 5.95 ng/mL) compared to non-smokers (28.05 ± 4.13 ng/mL, p = 0.000). No significant differences were observed in homocysteine (p = 0.958) or vitamin B12 (p = 0.578) levels between the two groups. A negative correlation was found between folic acid and systolic blood pressure in smokers, while no significant associations were noted among folic acid, vitamin B12, and homocysteine.
Conclusion: In patients with CVD, smoking is linked to significantly lower folic acid levels, which may lead to increased systolic blood pressure. These results underscore the need to monitor folic acid levels in smokers who are at risk for cardiovascular issues.
Priyadarshini Kumaraswamy Rajeswaran , Preethi Muthusamy Sundar, Prasanna Nedungadi Kumar, Karthikeyan Shanmugam,
Volume 19, Issue 3 (5-2025)
Abstract
Background: Several hematological indicators have been linked to the intensity and course of Coronavirus Disease of 2019 (COVID-19), including platelets, total white blood cell (WBC) count, lymphocytes, neutrophils (as well as the neutrophil-lymphocyte and platelet-lymphocyte ratios), and hemoglobin. The purpose of this study was to assess the utility of cell population data (CPD) of lymphocyte and monocyte parameters in the early diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection.
Methods: The baseline complete blood count examination was performed for 222 patients with positive results for COVID-19 (case group) and 161 patients with negative results for COVID-19 (control group). Lymphocyte and monocyte CPD were calculated in both groups. The independent t-test was used to compare the mean values between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminating capacity of the individual parameters.
Results: The analysis revealed that Standard Deviations of Monocyte Volume (SDMV) and Standard Deviations of Lymphocyte Conductivity (SDLC) showed the highest significance in predicting SARS-CoV-2 infection. Moreover, SDMV had a sensitivity of 93.7% and SDLC had a sensitivity of 80.6% at cut-off values of 22.25 and 10.9, respectively. In the case group, 49 of the 222 patients treated in the intensive care units (ICUs) showed a higher SDMV compared with the remaining 173 patients who were asymptomatic, or mildly symptomatic (P-value <0.03).
Conclusion: Our study demonstrates that SDMV and SDLC can serve as reliable and cost-effective markers for early prediction of SARS-CoV-2 infection. Furthermore, SDMV shows potential as a prognostic biomarker. These findings highlight the potential utility of CPD parameters in COVID-19 diagnosis and prognosis.
Anuradha Saini , Anjali Sharma , Mukul Singh , Shaily Goyal , Maninder Narang , Sunil Ranga ,
Volume 19, Issue 3 (5-2025)
Abstract
Background: Sepsis stands as a leading cause of mortality among critically ill patients in intensive care units (ICUs). Bacterial infections, including sepsis, upregulate Neutrophilic cluster of differentiation 64 (nCD64) expression on activated polymorphonuclear leukocytes (PMNs). Prompt diagnosis of sepsis is crucial for initiating timely and targeted treatment. Consequently, a rapid laboratory test with high specificity for sepsis in adults would significantly aid therapeutic decision-making and help reduce the overuse of antibiotics.
Methods: This study enrolled 40 sepsis patients diagnosed according to the Sepsis-3 definition. For biomarker evaluation, 2 mL blood samples were collected from each patient in both ethylenediaminetetraacetic acid (EDTA) and plain vials. In addition, nCD64 was analyzed using flow cytometry, high-sensitivity C-reactive protein (hs-CRP) via nephelometry, and procalcitonin (PCT) using chemiluminescence.
Results: For sepsis prediction, nCD64 demonstrated a positive predictive value (PPV) of 92.68% and a negative predictive value (NPV) of 94.87%. A receiver operating characteristic (ROC) curve was generated to assess the diagnostic accuracy of nCD64 (≥ 1.8), hS-CRP (≥ 3 mg/L), and PCT (≥ 0.4 ng/mL). The area under the curve (AUC) for nCD64 was highest at 0.938 (95% confidence interval [CI] = 0.876-0.999), followed by hS-CRP at 0.888 (95% CI = 0.807-0.968) and PCT at 0.850 (95% CI = 0.759-0.941).
Conclusion: These findings strongly suggest that nCD64 determination is a valuable diagnostic tool for identifying infections in patients with septic syndrome. Its performance appears to be superior to that of hs-CRP and PCT.
Sahar Siddiqui , Mohd Suhail Lone , Umar Amin Qureshi , Rayees Khanday ,
Volume 19, Issue 3 (5-2025)
Abstract
Background: Staphylococcus aureus (S. aureus) is a virulent bacterium responsible for a spectrum of infections, from superficial dermatological issues to severe, life-threatening sepsis. The emergence of methicillin-resistant S. aureus (MRSA) strains, encompassing both hospital-acquired (HA) and community-acquired (CA) variants, presents significant challenges to effective treatment, especially in pediatric sepsis cases. This research endeavored to characterize S. aureus sepsis in pediatric patients, differentiate between cases caused by CA S. aureus (CA-SA) and HA S. aureus (HA-SA), and evaluate patterns of antibiotic resistance.
Methods: This study, conducted between January 2021 and December 2022 at the Postgraduate Department of Pediatrics, Children’s Hospital, Srinagar, Kashmir, J&K, investigated patients aged 1 month to 18 years with suspected S. aureus sepsis or disseminated disease. Standard methods (BacT Alert and Vitek II Compact) were employed for culturing various samples. Continuous data are presented as mean ± standard deviation (SD), while categorical variables are expressed as proportions.
Results: Out of 56 patients, CA-SA was observed in 66.1% of cases, while HA-SA accounted for the remaining 33.9%. The cohort primarily consisted of males (62.5%) and individuals residing in rural areas (71.43%). Localized musculoskeletal symptoms were a prominent feature, present in 91.9% of patients (P ≤ 0.05). Pleuropulmonary disease showed an association with HA-SA, whereas necrotizing soft tissue infections were linked to CA-SA. Common clinical manifestations included pneumonia and abscesses. Complications (such as septic shock, respiratory failure, and multi-organ dysfunction) were more frequently encountered in patients with HA-SA. Among 50 culture-confirmed cases, 96% were identified as methicillin-resistant S. aureus (MRSA). Survival rates differed between the two groups, with 94.6% for CA-SA patients and 89.5% for HA-SA patients.
Conclusion: The current study reveals a high prevalence of MRSA in pediatric sepsis, emphasizing the critical need for urgent antimicrobial stewardship. The observed distinct clinical profiles of CA-SA and HA-SA further underscore the necessity for tailored management strategies, particularly in resource-limited environments.
Yashica Gowda R, Suja Ajoy Kumar, Karthik Srevatsa,
Volume 19, Issue 4 (7-2025)
Abstract
Background: The significance of blood transfusion is best captured by the phrase, "It's not just blood-it's liquid life." However, without proper safety measures, transfusion carries serious risks, including the transmission of highly infectious diseases. Among these, hepatitis B virus infection poses a major public health threat due to its high infectivity, potential for chronic infection, and severe complications. Despite the availability of an effective vaccine, hepatitis B virus remains a persistent challenge in transfusion medicine, underscoring the need for stringent screening and preventive strategies. This study aimed to determine the trend of hepatitis B surface antigen (HBsAg) seropositivity among the blood donor population over five years and its prevalence among voluntary and replacement donors.
Methods: This study was conducted at a licensed blood center of a tertiary care hospital. A retrospective review of blood donor data over five years was extracted. All donated blood was screened for the presence of HBsAg using commercially available ELISA kits. All repeatedly reactive samples were labelled seropositive. The data were analyzed for trends in the prevalence of HBsAg over the study period.
Results: A total of 18,139 healthy donors were screened during the study period. Among them, 11,517 were replacement donors and 6,622 were voluntary donors. The overall prevalence of HBsAg seropositivity was 0.66%, which was higher in replacement blood donors (0.46%). A decline in the incidence of HBsAg among donors was also observed over the five-year study duration.
Conclusion: Promoting and encouraging voluntary blood donation is a simple and effective way to reduce the prevalence of all transfusion-transmitted infections.
Sarah Ahmed Hasan, Waad Mahmood Raoof, Khaled Khalil Ahmed,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Carbapenems are broad-spectrum β-lactam antibiotics, often reserved as last-line treatment for infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Carbapenemase producing organisms (CPOs) pose a serious public health threat, contributing to severe healthcare-associated infections and increased mortality rates. This study aimed to determine the prevalence of CPOs and their antibiotic resistance patterns in isolates from burn and wound infections.
Methods: A total of 250 clinical samples (140 wound swabs and 110 burn swabs) were collected from hospitalized patients in Kirkuk and Sulaimaniyah hospitals between January and July 2023. Specimens were cultured on MacConkey agar and cetrimide agar and incubated at 37°C for 18–24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix™ M50 system, while carbapenemase production was confirmed using the BD RAPIDEC® CARBA NP assay.
Results: Among the isolates, 27 (38.02%) were confirmed as carbapenemase-producing and exhibited multidrug resistance. The distribution was as follows: Pseudomonas aeruginosa (44.44%, 12 isolates), Escherichia coli (33.33%, 9 isolates), Enterobacter cloacae (18.51%, 5 isolates), and Klebsiella pneumoniae (3.7%, 1 isolate). Notably, CP-P. aeruginosa and CP-K. pneumoniae showed the highest resistance, being resistant to 15 antibiotics across seven different classes.
Conclusion: This study reveals a high prevalence of MDR CPOs in burn and wound infections, likely due to antibiotic misuse or overuse. The findings highlight the urgent need for novel therapeutic strategies to combat carbapenem-resistant pathogens, which are associated with increased global morbidity and mortality.
Karthiga Vj , Arthy Raman , Subhashini Ramamoorthi , Debasis Gochhait , Sreerekha Jinkala ,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Conventional Tissue Processing (CTP) is the gold standard method for tissue processing; however, the method is relatively time-consuming. Microwave Tissue Processing (MTP) reduces the turnaround time and gives comparable histomorphology to CTP. The objective was to compare the Laboratory-grade Microwave Processing (LMP) and Domestic Microwave tissue Processing (DMP) with CTP in terms of histomorphology and immunohistochemistry (IHC) staining.
Methods: Three tissue bits from 89 formalin-fixed resection specimens received in the histopathology laboratory were processed by CTP, LMP, and DMP processing methods. The specimens were fixed in 10% neutral buffered formalin for 24 hours. The sections were stained with Hematoxylin and Eosin (H and E) stain. In subgroup analysis, IHC was done on 17 relevant cases using two antibodies, Ki67 (Nuclear) and Pancytokeratin (Membranous and cytoplasmic). Parameters such as the clarity of section, cytoplasmic details, nuclear details, color intensity, and interface of epithelium and connective tissue were studied. Parameters like color intensity, localization of antigen, background staining, and crispness of staining were studied on IHC. The results were analyzed using Kappa statistics.
Results: There was a fair to moderate agreement between CTP and LMP. There was a slight to fair agreement between CTP to DMP and LMP to DMP.
Conclusion: Microwave tissue processing reduced the turnaround time. The overall quality of LMP tissue was better than DMP and was equally good as that of CTP.
Shayosree Sarkar, Sonal Chavan, Geetika Agrawal, Heena Rahangdale, Sunanada Zodpey,
Volume 19, Issue 4 (7-2025)
Abstract
Background: Burkholderia cepacia complex (BCC) is an opportunistic nosocomial pathogen known to cause severe infections in neonates, including those affecting the respiratory and urinary tracts, as well as bloodstream infections. Consequently, BCC has the potential to instigate outbreaks originating from various sources. This study was undertaken to facilitate the early detection and effective control of a BCC-related outbreak.
Methods: A cross-sectional study, conducted in July 2023 at a tertiary care hospital, investigated bacterial isolates from neonates. Over a one-month period, eleven neonates' blood cultures grew motile, oxidase-positive, non-fermenting gram-negative bacilli. These isolates were presumptively identified as BCC based on conventional biochemical tests and their antimicrobial susceptibility profiles. The recurring isolation of an identical bacterial strain within the neonatal intensive care unit (NICU) strongly suggested an ongoing outbreak. Consequently, active surveillance was initiated to identify the source of the infection and implement containment measures. The identity of the isolated strains was subsequently confirmed using the VITEK 2 Compact microbiology analyser (BioMérieux, France).
Results: Surveillance identified the BCC sources for all 11 affected neonates. The investigation traced the infection origins to several environmental factors within the healthcare setting, including intravenous (IV) catheters and neonatal cradles, operating theatre (OT) beds, and instrument trolleys in the labour room where the deliveries occurred. Furthermore, all environmental BCC isolates demonstrated genetic relatedness to the clinical isolates concurrently exhibiting a similar antibiotic susceptibility pattern. Timely interventions were instrumental in controlling the outbreak.
Conclusion: This study highlights the critical role of the hospital infection control team in effectively managing a BCC outbreak among neonates.
Subaida Adalam Kunnath, Anandan Kalarikal Raghavan, Feroze Moosa , Aneesha Asok Kumar ,
Volume 19, Issue 5 (9-2025)
Abstract
Background: COVID-19 is a global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Various clinical and hematological findings have been identified that can predict disease severity. This study aims to investigate the roles of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-platelet ratio (NPR) in predicting the severity of COVID-19 infection.
Methods: In this analytical cross-sectional single-center study, after obtaining Ethics Committee clearance, patients with laboratory-confirmed COVID-19 infection admitted during their first two weeks of illness were included. NLR, PLR, and NPR were derived from the CBC reports. These ratios were compared in each clinical category group to assess the severity.
Results: The total number of cases was 160, with a mean age at diagnosis of 56 years. The proportion of males was slightly higher (54.4%) than that of females (45.6%). The proportion of Category C patients (66.9%) was higher than that of Category B (25%) and Category A (8.1%) patients. It was found that NLR, PLR, and NPR ratios had a statistically significant association with severe COVID-19 infection, suggesting they can be used to differentiate between Category C and Category A or B. NLR is a better predictor of the severity of COVID-19 disease than PLR and NPR.
Conclusion: NLR, PLR, and NPR ratios can serve as predictive markers of disease severity in COVID-19 infections. Among these ratios, NLR has the highest predictive value for disease deterioration.
Faeze Shahriyari , Seyyede Fatemeh Shams , Mehrnaz Abdolalian , Narjes Soltani , Hashem Honari , Leila Rafaty Javanbakht, Mohammadreza Javan ,
Volume 19, Issue 5 (9-2025)
Abstract
Background: Blood transfusion services are responsible for providing blood products. Knowing the parameters that affect people’s decision to donate blood will help respond to this demand. This study was designed to assess the attitudes and barriers toward blood donation among volunteer donors in Mashhad (Northeast of Iran) during 2014-2015.
Methods: This cross-sectional study was performed in Iranian Blood Transfusion Organization centers in Mashhad. A total of 640 volunteer blood donors, including first-time and frequent donors, attended this study. The questionnaire was designed based on similar studies, and the reliability and validity were controlled. A questionnaire consisting of multiple-choice questions was provided to the participants. SPSS software was used for data analysis. The Student’s t-test was used, and P<0.05 was considered significant.
Results: Among the 640 participants, 80% completed and returned the questionnaire. Of the participants, 474 (92.5%) were male and 38 (7.4%) were female. A total of 114 donors were first-time donors, and the others had donated blood before. The most important motivations for blood donation included altruism: 249 (91.88%) among frequent donors and 76 (85.40%) among first-time donors. Other factors such as social influences also played a role. Lack of time (73.80%) was the most important barrier to blood donation among the first-time donors.
Conclusion: The results showed that the most important motive and barrier for blood donation were altruism and lack of time, respectively. In other words, paying attention to the motivations and barriers of blood donation can play an important role in attracting and retaining blood donors.
Kavitha Prabhu, Rashmi Dsouza, Santhosha Devadiga, Beena Antony, Meena Dias,
Volume 19, Issue 6 (11-2025)
Abstract
Introduction
Candida species cause significant morbidity and mortality in vulnerable populations. Recent reports suggest a shift in the epidemiological trend to non albicans Candida infections from Candida albicans. This study was done to speciate candida from clinical samples using Matrix Assisted Laser Desorption Ionization – Time of Flight Mass spectrometry (MALDI-TOF MS) Analysis.
Materials and Methods
All routine clinical samples received in the bacteriology and mycology sections were processed using standard protocol. Candida species recovered from various clinical samples were speciated using MALDI-TOF MS from September 2022 to November 2023 and results were tabulated and analyzed statistically.
Results: A total of 342 Candida species were isolated during the study period. Median age of the patients presenting with candidiasis was 46.5 years with male predominance. Non albicans Candida species were predominant with C.tropicalis (30.40%), the most common species followed by C.parapsilosis(14.32%). Forty strains of C.auris isolates were found during this 15 months study period (11.69%).
Conclusion: The role of Candida species, including the non albicans Candida and newly emerging drug resistant candida strains should be dealt with caution. With its rapid and accurate results, MALDI-TOF MS can replace conventional and automated machines which are based on biochemical reactions for the speciation of Candida isolates.
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