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Abstract Background International normalized ratio (INR) derivation is dependent on the international sensitivity index (ISI) of thromboplastin. It varies with instrument and reagents used. Objective To evaluate the role of a correction factor in the derivation of INR. Methods We studied prothrombin time (PT) and INR from patients using 3 thromboplastins of varying ISI values. The correction factor was applied to the observed INR to obtain a corrected INR. Results The difference between corrected INR and observed INR values varies from −0.8 through 0.96. Conclusions Corrected INR is dependent on PT only. It can be applied to all patients irrespective of cause for elevated PT.

Platelet distribution width (PDW) and mean platelet volume are markers of platelet activation and have prognostic value in coronary heart diseases, as well as in cancers of solid organs. In this study, we evaluated the possibility of using PDW to predict chronic myeloproliferative neoplasms by comparing platelet indices obtained by automated analyzers in chronic myeloproliferative neoplasms with those in control specimens. We found that PDW greater than 66.4% has specificity of 99% and likelihood ratio of 19.5 for predicting chronic myeloproliferative neoplasms. Also, the area under curve (AUC) for platelet distribution width is 0.68.

To determine any difference in levels of minor hemoglobins, other than hemoglobin A2 (HbA2), in patients with iron deficiency. We divided ethylenediaminetetraacetic acid (EDTA)-anticoagulated blood specimens from 188 patients into 2 groups, of which 94 displayed a normal or high ferritin level and the remaining 94 had a low ferritin level. We correlated the red cell indices, hemoglobin levels, and ferritin levels with the percentage of various minor hemoglobins. The Student's t-test was used to assess the statistical significance of the difference between the mean concentrations of minor hemoglobins in the 2 groups. Only hemoglobin HbA1a had a positive correlation (0.33 in iron-deficient and 0.35 in iron-replete specimens) with serum ferritin concentration. Among the minor hemoglobins, HbA1a (P =.008) and HbA2 (P <.001) were significantly different between the 2 groups. HbA1a may be low in iron deficiency, independent of HbA2. This information may be used to predict coexistent iron deficiency in β-thalassemia traits, in which concomitant infection or inflammation leads to normal ferritin levels.

ABSTRACT anemias and sporadically in few other conditions. Here, we report a case of florid erythrophagocytosis with severe anemia following a viral infection in an 18-year-old girl. Her complete blood count (CBC) revealed hemoglobin of 3.6 gm/dl and a hematocrit of 10%. The peripheral smear showed erythrophagocytosis by neutrophils and rosetting of erythrocytes around neutrophils. The direct Coombs test and direct Donath- Landsteiner tests were positive.

Abstract Objective Examination of urine sediment is crucial in acute kidney injury (AKI). In such renal injury, tubular epithelial cells, epithelial cell casts, and dysmorphic red cells may provide clues to etiology. The aim of this study was to compare automated urinalysis findings with manual microscopic analysis in AKI. Methods Samples from patients diagnosed with AKI and control patients were included in the study. Red blood cells, white blood cells, renal tubular epithelial cells/small round cells, casts, and pathologic (path) cast counts obtained microscopically and by a UF1000i cytometer were compared by Spearman test. Logistic regression analysis was used to assess the ability to predict AKI from parameters obtained from the UF1000i. Results There was poor correlation between manual and automated analysis in AKI. None of the parameters could predict AKI using logistic regression analysis. However, the increment in the automated path cast count increased the odds of AKI 93 times. Conclusion Automated urinalysis parameters are poor predictors of AKI, and there is no agreement with manual microscopy.

To establish a cutoffpoint for the automated basophil differential at which point smear review becomes essential. We reviewed 184 blood samples for atypical lymphocyte flagging. At the arbitrary basophil cutoffpoints of 0, 0.6%, 1.2%, 1.8%, 2.4%, 3.0%, and 3.6%, we calculated the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for atypical lymphocyte flagging. Using this information, we plotted the receiver operating characteristic (ROC) curve. Seventy-nine samples had atypical flagging and a mean basophil differential of 2.086%. In 105 samples with no atypical flagging, the mean basophil differential was 0.750%. The sensitivity, specificity, NPV, and PPV were 73.4%, 81.9%, 80.3%, and 75.3%, respectively at the basophil cutoffpoint of 1.2%; the area under the ROC curve was 0.70. Among samples with no atypical flagging, 2 peripheral smears (with basophil differentials of 1.8% and 3.8%, respectively) also contained reactive lymphocytes. We recommend the automated basophil count of 1.2%, as measured by the ADVIA 2120 analyzer, as the criterion for smear review, which may be used as an independent marker of atypical lymphocyte morphologic manifestations.

Background Recurrent genetic abnormalities influence prognosis in B lymphoblastic leukemia. BCR‐ABL rearrangement is associated with higher leukocyte counts and older age at presentation. Among adults, BCR ‐ABL ‐ is the commonest recurrent abnormality whereas, IgH rearrangements are rare. Aim Aim of this study was to identify common recurrent genetic abnormalities in adult B ALL and study their association with hematological findings. Methods Bone marrow and peripheral blood from patients with B acute lymphoblastic leukemia were analyzed for complete blood counts, bone marrow morphology and cytogenetic abnormalities. The study group was divided into smaller groups based on cytogenetic abnormalities. Hematological parameters and presence of recurrent genetic abnormalities was compared across age groups and gender by non parametric tests. Results BCR‐ABL positive group had a higher leukocyte count than BCR‐ABL negative group. Among groups 1 to 5, group 1 with gains of chromosomes was associated with leucopenia and higher age at presentation. BCR‐ABL is commonest recurrent abnormality followed by IgH rearrangements. Conclusion Patients with gains of chromosomes alone have low total leukocyte counts at presentation.

Background Driver mutations are seen in 80% of lung adenocarcinomas, and they influence prognosis and choice of therapy. Aim Aim of this study was to analyse the frequency of epidermal growth factor receptor (EGFR) mutations, ALK and ROS1 rearrangements and their association with age and gender in non‐small cell lung cancer reported from a tertiary care center in South India. Methods Tumors from patients with non‐small cell carcinoma of lung were evaluated for EGFR mutations, ALK and ROS1 rearrangements and their association with age and gender were studied. Results Two thirds of non‐small cell carcinomas had driver mutations or rearrangements. EGFR mutation was common and seen in 34.1%, whereas ALK rearrangement was seen in 11.1% and ROS1 rearrangement in 2% patients. Among EGFR mutations, most common were Exon 19 deletion and L858R seen in 21.3% and 11% of patients, respectively. Adenocarcinoma was the histologic diagnosis in 81% to 85% of patients with exon 19 deletion and L858R mutation, respectively. EGFR mutation frequency in patients less than 36 years was 13.6%, whereas in older patients, it varied from 34% to 36%. Exon 19 deletion was seen in 29.8% females and 17.2% of males. Conclusion EGFR mutations are more common than ALK and ROS1 rearrangements. They are more common in females. Patients less than 36 years have reduced frequency of EGFR mutations. Exon 19 deletion and L858R are most common and are more prevalent in lung adenocarcinomas. Rare EGFR mutations are seen in patients aged more than 50 years.

Abstract Objectives To analyze the most common primary and secondary cytogenetic events in myelomas using a probe panel designed in our laboratory, and to associate those events with hematological and biochemical findings. Methods Blood specimens from patients diagnosed with myeloma were processed to determine complete blood count and levels of albumin, creatinine, and beta-2 microglobulin. We evaluated bone-marrow specimens for plasma-cell percentage by light microscopy and for cytogenetic abnormalities by fluorescence in situ hybridization (FISH). The Mann-Whitney U test was used to compare hematological and biochemical parameters. Results We observed immunoglobulin heavy chain (IgH) gene translocations in 43.3% and t(4;14) in 21% of specimens; t(11;14) was observed in 7.7% of specimens. Gain of chromosomes was observed in 67.2% and loss observed in 16.6% of specimens. Conclusions Gains of chromosomes were observed in two-thirds of patients with myeloma. The most common IgH translocation was t(4;14); del13/monosomy13 was the most common secondary cytogenetic abnormality. Partial or complete tetrasomies were associated with higher beta-2 microglobulin levels.