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Assessment of Liver and Kidney Functional Parameters along with Oxidative Stress and Inflammatory Biomarker in Patients with β- Thalassemia Major
Dr Mehrnoosh Shanaki, Dr Hassan Ehteram, Ms Hajar Nasiri, Dr Mehdi Azad, Dr Fatemeh Kouhkan, Dr Reza Pakzad , Dr Naser Mobarra,
Volume 6, Issue 4 (11-2016)
Abstract

Abstract
Background:

Thalassemias are the most common inherited blood disorders caused by some mutations which can reduce the synthesis of globin chains. Iron overload and its organ deposition are responsible for functional abnormalities and tissue injury in patients who affected by β-thalassemia major. The aim of this case-control study was evaluation of hematological parameters, oxidative stress and some serum liver and kidney risk factors which play crucial role for early prediction and prevention of patients to end-stage tissue failure and mortality.
Materials and Methods:

the present study consisted of Fifty young adult subjects with β-thalassemia major (β- TM) (aged<18 years) and same number age and sex- matched healthy subjects as control group. Hematological and biochemical laboratory parameters included Urea, Creatinine, Uric Acid, Aspartate Aminotransferase (AST), Alanine transaminase (ALT), Alkaline phosphatase (ALP) (pars azmoon kit), oxidative stress biomarker PAB, giving a redox index (chemically), and serum high-sensitivity C-reactive protein (hs-CRP) were evaluated.
Results:

Urea, Creatinine and Uric Acid were significantly decreased in patients group (P<0.001); in spite of, serum ferritin, liver biomarkers AST, ALT, ALP and risk factor biomarker PAB were statistically increased in patients versus control group(P<0.001), whereas hs-CRP(P>0.05) was not significantly difference in study groups. Exception hs-CRP and PAB (P>0.05), liver risk factors had a positive correlation with ferritin and serum Urea, Creatinine and Uric Acid tests had negative meaningful with hematological parameters (P<0.001). Likewise, PAB with AST showed a positive correlation (P<0.001) and irreversibly with urea and creatinine (P<0.001). We did not find a slight correlation between hs-CRP in the company to hematological and biochemical laboratory finding (P>0.05).

Conclusion:

Higher level of risk factors PAB values and key liver enzyme profiles are able to involve in the prognostic pathological consequences in patients with β-thalassemia major. Even so, they contribute toward the gradual development of tissue injuries.


Diagnostic Evaluation of Hematological Sepsis Score and Presepsin in Neonatal Sepsis
Dr Marina Mamdouh Malky Ibrahim, Dr Dalia Ahmed El-Sewefy, Dr Mariam John Amin Ibrahim, Dr Shaimaa Abdelmalik Pessar,
Volume 12, Issue 2 (4-2022)
Abstract
Background: Early detection of neonatal sepsis and categorization of patients based on clinical severity is not yet effectively achieved. Some hematological parameters are used to formulate a hematological scoring system (HSS) and a modified hematological scoring system (MHSS) to diagnose neonatal sepsis. A promising biomarker: Presepsin, or Soluble Cluster of Differentiation 14 SubType (sCD14-ST), is a proteolysis product of CD14 produced after immune activation during infections. The purpose of this research is to assess the performance of both hematological sepsis scores and serum presepsin level in neonatal sepsis and compare them to C-reactive protein (CRP) as diagnostic tools and predictors of mortality.
Materials and Methods: This case-control study comprised two groups, one group comprised 51 neonates who were further subgrouped into suspected & proved sepsis, along with 30 uninfected neonates as the control group. Both groups were subjected to the calculation of HSS and MHSS, serum presepsin levels, CRP measurement, and blood culture and assessed for clinical severity and mortality.
Results: Hematological sepsis scores and presepsin levels were significantly higher in the sepsis group (P <0.001). Presepsin showed the best diagnostic performance at > 0.5 ng/ml (AUC 0.979; sensitivity of 94.1% and specificity of 100%). While HSS and MHSS at a cutoff value > 1 achieved comparable specificity, lower sensitivity, 72.6% for the former and 76.5% for the later was noted. Presepsin also was significantly higher in the dead group (P<0.004) with the best predictive performance over CRP at cutoff value >1.9 ng/ml (AUC 0.838; sensitivity of 85.7% and specificity of 79.6%).
Conclusion: Hematological sepsis scores and presepsin were useful diagnostic tools in neonatal sepsis, with presepsin as a good predictor of mortality comparable to CRP.

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