International Journal of Research and Reports in Hematology

Silent Multiorgan Injury in Sickle Cell Disease: Redefining Mortality Beyond Pain Crises

Tue, 02 Jun 2026 00:00:00 +0000

Sickle cell disease (SCD) has typically been seen through the prism of acute vaso-occlusive crises and other clinically noticeable issues that call for medical attention. The mortality rate among people with sickle cell disease (SCD) is still much higher than that of the general population, despite improvements in survival and a decrease in the frequency of severe acute episodes brought about by advancements in disease-modifying treatments and supportive care. A significant amount of this increased mortality may be caused by silent, progressive multiorgan harm that occurs long before clinical symptoms manifest, according to emerging data. The objective of this review was to evaluate the contribution of silent multiorgan injury to sickle cell disease morbidity and mortality, as well as its underlying pathophysiological mechanisms, patterns of organ-specific damage, diagnostic limitations, and potential for early detection and prevention. A narrative review of the literature was conducted using published studies addressing the mechanisms, manifestations, detection, and management of subclinical organ injury in SCD. The review found that the main causes of silent tissue damage were endothelial dysfunction, oxidative stress, persistent haemolysis, chronic inflammation, hypercoagulability, and repeated microvascular occlusion. The brain, kidneys, liver, spleen, cardiovascular system, and skeletal system are all gradually affected by these processes, frequently years before obvious clinical symptoms show up. Avascular necrosis, higher tricuspid regurgitant velocity, diastolic dysfunction, silent cerebral infarcts, microalbuminuria, and functional asplenia were found to be significant markers of subclinical disease development and unfavourable long-term outcomes. Current therapies have a limited ability to prevent the increasing organ deterioration, and current clinical techniques are still primarily focused on acute problems and often miss early organ damage. The narrative structure of this review and the lack of quantitative synthesis are its main limitations. All things considered, a significant yet underappreciated factor in sickle cell disease morbidity and early death is silent multiorgan damage. To enhance long-term results and address the hidden burden of disease, there must be a greater focus on proactive surveillance, early detection, and organ-protective therapies.

Automated Haematology in Infectious Disease Diagnosis and Management: A Critical Review with Special Reference to Nigeria

Erens Spiff Ekprikpo — Fri, 24 Jul 2026 00:00:00 +0000

Automated haematology analysers have transformed the way clinicians detect, monitor, and manage infectious diseases, moving the complete blood count from a slow manual procedure into a rapid, multi-parameter diagnostic platform. This review examines the technological evolution of these analysers and synthesises the evidence linking specific hematological signatures to major infections of relevance to tropical and sub-Saharan settings, with particular attention to Nigeria, a country carrying one of the highest burdens of malaria, tuberculosis, human immunodeficiency virus infection, typhoid fever, and viral haemorrhagic fever in the world. The review traces the shift from impedance-based three-part differential counters to modern flow-cytometric and fluorescence-based platforms capable of generating extended research parameters, and it appraises derived indices such as the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as low-cost adjuncts for triage and prognosis. Particular emphasis is placed on the practical realities of Nigerian clinical laboratories, where workforce shortages, unstable electricity supply, and uneven access to modern analysers continue to constrain diagnostic capacity even as malaria, Lassa fever, and bloodstream infections make rapid haematological assessment clinically urgent. The review further considers artificial intelligence-enabled digital morphology systems and deep learning approaches to automated parasite detection, evaluating their potential to narrow the gap between microscopy expertise and diagnostic demand in resource-constrained settings. Persistent challenges are identified, including inconsistent reference intervals for African populations, limited external quality assurance coverage, fragile cold chains and power supplies, and the disproportionate cost of advanced platforms relative to national health budgets. The review concludes that automated haematology, when integrated thoughtfully with point-of-care innovation, digital decision support, and strengthened laboratory governance, holds substantial promise for improving infectious disease diagnosis and management in Nigeria and comparable settings, provided that technology adoption is matched by investment in infrastructure, workforce training, and standardisation.

Internal Quality Control in the Haematology Laboratory: Practices and Challenges

U. Chinedu-Madu Jane, C. Aloy-Amadi Oluchi — Thu, 12 Nov 2026 00:00:00 +0000

Background: Internal quality control (IQC) is central to reliable haematology testing because plausible analytical results may still be sufficiently inaccurate to affect clinical decisions. Effective IQC therefore requires more than routine testing of commercial controls and should be integrated with analyser surveillance, specimen quality, staff competence, reagent management, equipment maintenance and result validation.

Objective: This review examines the principles and routine practices of IQC in haematology laboratories, including statistical interpretation, automated and manual procedures, and common implementation challenges, with attention to resource-constrained settings.

Main Discussion: A sustainable IQC programme requires a written, risk-based plan that defines controlled measurands, control levels, testing frequency, target means, standard deviations, acceptance limits, review responsibilities and responses to failure. Levey–Jennings charts and appropriate statistical rules should be interpreted alongside analyser flags, background checks, carry-over assessment, patient-based monitoring, delta checks and blood-film review. Manual cell counts, haemoglobin methods, erythrocyte sedimentation rate, morphology and coagulation testing require method-specific controls and careful management of observer and procedural variation.

Conclusion: Major challenges include the cost and intermittent supply of control materials, unstable electricity, environmental limitations, delayed equipment service, inadequate staffing, weak documentation and inappropriate responses to failed controls. Improvement depends on management commitment, locally verified procedures, disciplined troubleshooting, regular trend review and external quality assessment.

Effect of Some Haematological, Haemostatic and Inflammatory Markers on Parity in Cervical Cancer Patients in Port Harcourt

Abiye Chiladi Isomah, Princess Nmerukini Ewhorlu, Chiladi Jeff Isomah — Sat, 06 Jun 2026 00:00:00 +0000

Most cervical cancers are caused by Human Papillomavirus (HPV), the most common sexually transmitted infection that causes warts in various parts of the body. Cervical cancer is the second common female malignant tumor globally that seriously threatens females’ health. This study was aimed at determining the effect of some Haematological, Haemostatic and Inflammatory Markers on Parity in cervical cancer patients in Port Harcourt. This study was a case-control study. A total of 40 participants (20 histologically confirmed cervical cancer positive subjects and 20 histologically confirmed cervical cancer negative subjects) within the age of 18-70 years were recruited for this study. The demographics and informed consent of the study subjects were obtained with the use of a questionnaire. Eight millilitres (8mls) of blood sample were collected using vacutainers from each participant. Weight, height and body mass index (BMI) were recorded. Von Willebrand Factor (vWF), thrombomodulin, FVIII, Tissue plasminogen activator, D-dimer and C-reactive protein were analysed using ELISA technique. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analysed using manual method; fibrinogen was analysed using the coagulation method, plasma viscosity was analysed using capillary viscometer tube method while erythrocyte sedimentation rate (ESR) was analysed using the Westergren tube method. GraphPad Prism 8.0.2.263 version was used for data analysis. Analysis of variance (ANOVA) was used for different groups. P<0.05 was considered significant. Results were presented as mean ± standard deviation (m±SD) in Tables and Figures. This research work also revealed no statistically significant difference in all haematological parameters of cervical cancer patients vs control subjects based on parity. Therefore, parity plays no role in the alteration of haematological parameters as a result of the disease. The study also revealed a statistically significant linear increase in fibrinogen concentration in cervical cancer subjects based on parity. Subjects who have given birth to more than 4 children recorded a significant increase in their fibrinogen concentration. Other parameters indicated no statistically significant difference. This study revealed that parity does not directly play a significant role in cervical cancer disease.

Prevalence of Rhesus Antibodies (Anti-C, -D, and -E) among Pregnant Women in Ekpoma, Edo State, Nigeria

J. Inekhomon, K. C. Lele, E. G. Oikherhe, R. A. Amaechi — Sat, 04 Jul 2026 00:00:00 +0000

Rhesus alloimmunisation remains a major cause of haemolytic disease of the newborn (HDN), particularly among Rh-negative women exposed to Rh-positive foetal red blood cells. This study investigated the prevalence of Rhesus (Rh) antibodies, specifically anti-C, anti-D and anti-E, among pregnant women in Ekpoma, Edo State, Nigeria. A cross-sectional design was used, involving 101 pregnant women recruited from two antenatal clinics by simple random sampling. Blood samples were tested for Rh antigen status using tile agglutination, and antibody screening was performed using the indirect antiglobulin test. Sociodemographic and obstetric data were collected and analysed using SPSS version 21, with p ≤ 0.05 considered statistically significant. The prevalence of each Rh antibody, anti-C, anti-D and anti-E, was approximately 1%, with all three antibodies detected in a single nulliparous woman aged 18–24 years. No statistically significant associations (p > 0.05) were observed between antibody prevalence and maternal age, gestational age, marital status or parity. These findings suggest a low prevalence of Rh alloimmunisation in the study area, while supporting the continued need for routine antenatal Rh antibody screening and appropriate prophylactic intervention to reduce the risk of HDN. Further studies with larger samples and inclusion of transfusion history are recommended.

Knowledge of Causes and Care of Neonatal Jaundice among Nursing Mothers attending Federal Medical Centre, Umuahia, Abia State, Nigeria

Elekeh Rosemary Ichita, Ikeji Mary Ezinne, M. Onu Nwanneka — Mon, 06 Jul 2026 00:00:00 +0000

Background: Neonatal jaundice is a common neonatal condition that may result in serious complications when recognition and appropriate care are delayed. Maternal knowledge is important for early identification, timely care-seeking and avoidance of unsafe home practices. This study assessed knowledge of the causes and care of neonatal jaundice among nursing mothers attending Federal Medical Centre, Umuahia, Abia State, Nigeria.

Methods: A descriptive cross-sectional survey design was used. A total of 384 nursing mothers attending Federal Medical Centre, Umuahia, participated in the study. Data were collected using a structured questionnaire that assessed socio-demographic characteristics, perception of neonatal jaundice, knowledge of causes, maternal care practices and beliefs, and perceived barriers to orthodox care. Data were analysed using frequencies, percentages and mean scores. A benchmark mean score of 3.5 and above was interpreted as positive.

Results: Most respondents were married, had tertiary education and were aged 30-34 years. Respondents showed good awareness that neonatal jaundice is common in newborns, that infection increases the risk of neonatal jaundice and that severe jaundice may cause neonatal death. However, knowledge gaps were observed regarding breastfeeding-related jaundice, rebound hyperbilirubinaemia and specific treatment principles. Some misconceptions persisted, including beliefs related to sunlight exposure and sugar water. Major perceived barriers to orthodox care included high treatment cost, lack of money for laboratory tests and drugs, long waiting time at the hospital, fear of phototherapy and hospital equipment, cultural beliefs, advice from relatives or elders, and previous hospital experience.

Conclusion: Nursing mothers demonstrated reasonable awareness of neonatal jaundice, but important gaps in knowledge and care practices remain. Strengthened maternal education, clearer counselling during antenatal and postnatal visits, and improved access to affordable neonatal care are needed to promote early recognition and appropriate management.

Phenotype Frequencies of P1 Blood Group Antigen among Residents in Calabar, Nigeria

Joyce Ezekiel Etura, Gabriel Ebiriene Ubokikwan, Zaccheaus Awortu Jeremiah — Sat, 11 Jul 2026 00:00:00 +0000

Introduction: The P1 blood group antigen is part of a clinically relevant blood group system that plays an important role in blood transfusion. The prevalence of the P1 blood group antigen among individuals in Calabar, Cross River State, Nigeria, is not yet known.

Aims: This study determined the phenotype frequency of P1 antigen among residents of Calabar metropolis and described its distribution by ABO/Rh blood group, gender and ethnicity.

Materials and Methods: A cross-sectional study design was employed, and a total of 100 individuals who provided informed consent were enrolled. Fifty-nine (59) participants were males and forty-one (41) were females. The P1 blood group was analysed using the standard serological tube technique with Lorne reagent purchased from Lorne Laboratory, Great Britain, United Kingdom.

Results: The frequency of P1 antigen in this study was 71 (71.0%). The distribution of ABO/Rh blood groups among the participants was as follows: O Rh 'D' positive, 77 (77.0%); A Rh 'D' positive, 10 (10.0%); B Rh 'D' positive, 9 (9.0%); AB Rh 'D' positive, 1 (1.0%); A Rh 'D' negative, 1 (1.0%); and O Rh 'D' negative, 2 (2.0%). The most prevalent ethnic group was Efik, 46 (46.0%), followed by Igbo, 18 (18.0%); Ijaw, 10 (10.0%); Ibibio, 10 (10.0%); Anang, 7 (7.0%); Oron, 4 (4.0%); Hausa, 3 (3.0%); and Yoruba, 2 (2.0%).

Conclusion: A prevalence of 71.0% of P1 antigen was recorded among individuals in Calabar metropolis in this study. Although P1 antigen is a lesser-known blood group antigen and its complications are not as widely documented as those of major blood group systems, such as ABO and Rh, it may still influence transfusion reactions, immune responses and disease susceptibility.

Haematological Modulatory Effects of Ethanol Leaf Fractions of Sida acuta and Ficus exasperata, Alone and in Combination, in Alloxan-Induced Diabetic Wistar Rats

Tue, 14 Jul 2026 00:00:00 +0000

This study evaluated the haematological modulatory effects of ethanol leaf fractions of Sida acuta and Ficus exasperata, singly and in combination, in alloxan-induced diabetic female Wistar rats. Sixty-three female rats were divided into nine groups (n = 7): A, normal control; B, untreated diabetic control; C, glibenclamide at 0.29 mg/kg; D and E, S. acuta at 200 and 400 mg/kg, respectively; F and G, F. exasperata at 200 and 400 mg/kg, respectively; H, combined 200 mg/kg (100 mg/kg of each fraction); and I, combined 400 mg/kg (200 mg/kg of each fraction). Except for Group A, all groups were diabetic. Diabetes was induced with a single intraperitoneal injection of alloxan monohydrate (150 mg/kg body weight), and treatments lasted for 28 days. Blood was collected into ethylenediaminetetraacetic acid bottles and analysed using an automated haematology analyser. Compared with Group A, Group B showed reduced haemoglobin concentration (Hb), packed cell volume (PCV), red blood cell count and platelet count, with increased total white blood cell count (WBC). Hb and PCV decreased from 12.23 ± 0.78 g/dL and 43.05 ± 2.10% in Group A to 10.65 ± 0.27 g/dL and 37.23 ± 1.20% in Group B. Group I produced Hb and PCV values of 12.23 ± 0.56 g/dL and 44.68 ± 1.43%, respectively, and reduced WBC to 6.44 ± 1.67 × 10⁹/L. Group G had the highest platelet count, at 1061.00 ± 231.83 × 10⁹/L. The fractions produced dose- and treatment-dependent changes in selected haematological indices, with Group I showing the most favourable responses in Hb, PCV and WBC.

Evaluation of Haematological Indices in Rheumatoid Arthritis Subjects in Port Harcourt, Nigeria

Gold Nkolika Mbeera, Evelyn Mgbeoma Eze, Serekara Gideon Christian — Fri, 17 Jul 2026 00:00:00 +0000

Background: Rheumatoid arthritis is a chronic autoimmune inflammatory disorder that may cause measurable haematological changes. Evidence describing these alterations among Nigerian subjects remains limited.

Aim: This study evaluated haematological indices in rheumatoid arthritis subjects in Port Harcourt, Nigeria.

Methods: A cross-sectional study included 78 participants aged 35–75 years, comprising 31 rheumatoid arthritis subjects and 47 apparently healthy controls. Full blood count parameters were measured using a Mindray BC-5800 five-part automated analyser. Data were analysed using GraphPad Prism version 10.6.1, with statistical significance set at p ≤ 0.05.

Results: Rheumatoid arthritis subjects had significantly higher neutrophil counts, mean corpuscular haemoglobin concentration, and platelet-to-lymphocyte ratio than controls. Conversely, lymphocyte counts, red blood cell counts, and packed cell volume were significantly lower. Female rheumatoid arthritis subjects showed significantly increased neutrophil count, neutrophil-to-lymphocyte ratio, and mean corpuscular haemoglobin concentration, together with reduced lymphocyte count. Among male rheumatoid arthritis subjects, mean corpuscular volume and mean corpuscular haemoglobin were significantly higher, whereas the remaining measured indices did not differ significantly from those of male controls.

Conclusion: Rheumatoid arthritis was associated with selected inflammatory and erythrocyte-related haematological alterations, with more pronounced inflammatory differences among female subjects. Routine full blood count-derived indices may provide accessible supplementary information during clinical assessment, although their interpretation should remain integrated with disease activity, treatment history, and other clinical findings.

Effect of Methanolic Leaf Extract of Ficus capensis on Iron Status Biomarkers in Phenylhydrazine-induced Anaemic Wistar Rats

Isaiah Audu, I. K. Kwaifa, F. U. Onuigwe, H. M. Alhassan, U. Abubakar — Sat, 18 Jul 2026 00:00:00 +0000

Iron deficiency anaemia (IDA) is a condition characterised by a decrease in the number and size of red blood cells, leading to inadequate oxygen delivery to tissues and organs. It is the most common nutritional disorder worldwide, affecting approximately 1.6 billion people globally, and may be caused by insufficient iron intake, impaired absorption or chronic blood loss. The main causes of IDA can be classified into three categories: inadequate dietary iron intake, increased iron requirements and chronic blood loss. This study aimed to evaluate the effects of the methanolic leaf extract of Ficus capensis on selected haematological parameters in phenylhydrazine-induced iron-deficiency anaemic Wistar rats. This experimental study comprised 36 Wistar rats with five rats in each group. Group 1 served as the normal control, group 2 as the negative control, group 3 as the positive control, group 4 as the low-dose group, group 5 as the medium-dose group, group 6 as the high-dose group and group 7 as the extract plus ferrous sulphate group. The results showed significant elevation of TIBC in the positive control group compared with the negative control. Ficus capensis extract markedly reduced TIBC in a dose-dependent manner, with the lowest TIBC observed in the standard-drug group. The low- and medium-dose extract-treated groups also demonstrated significant reductions. Quantitative phytochemical screening of the methanolic leaf extract of Ficus capensis indicated the presence of Geranic acid, 1,4 Heptadia,3-methyl, beta.-Amyrin, Squalene, Bis(2-ethylhexyl)phthalate, Ethyl 9,12,15-octadecatrienate, 10-Dodecadia-1-o1, 3,7,11-trimethyl-, (E) (.+/-.)-, Phytol, 11-Octadecenic acid, methyl ester, 9,12-Octadecenic acid,methyl ester, (E, E)-, 6,6-Dimethylhepta2,4-diene, n-Hexadecan acid and Hexadecanol acid, methyl ester. This shows that the methanolic extract of Ficus capensis leaves contains a complex mixture of fatty acids, esters, terpenoids and hydrocarbon phytochemicals typically associated with antioxidant, anti-inflammatory, antimicrobial and haematopoietic activities. No mortality was observed after oral administration of the methanolic leaf extract of F. capensis at doses up to 5000 mg/kg. From the findings of this study, the methanolic extract of Ficus capensis leaves had no observed toxic effect, even at a dose of 5000 mg/kg body weight, and the acute toxicity value after 24 hours was greater than 5000 mg/kg body weight. In conclusion, alterations in serum iron, ferritin, transferrin saturation and total iron-binding capacity (TIBC) among the experimental groups reflected the modulatory effect of Ficus capensis methanolic leaf extract on iron metabolism. Transferrin saturation percentage was markedly reduced in the positive control compared with the negative control, consistent with iron depletion.

Serum Vitamin B12 and Creatine Kinase Status and Their Relationships with Haematological Parameters in Nigerian Sickle Cell Anaemia Patients

Fri, 04 Sep 2026 00:00:00 +0000

Aims: To determine serum vitamin B12 and creatine kinase levels and to establish their relationships with selected haematological parameters among patients with sickle cell anaemia attending a tertiary hospital in southwestern Nigeria.

Study Design: A cross-sectional comparative study.

Place and Duration of Study: Department of Haematology Laboratory, University College Hospital, Ibadan, Oyo State, Nigeria, as part of a postgraduate research programme completed from July 2025 to July 2026.

Methodology: Two hundred and fifty participants were enrolled, comprising 150 confirmed HbSS sickle cell patients in steady state and 100 apparently healthy HbAA controls. Ten millilitres of venous blood was collected from each participant. Full blood count parameters were determined on an automated haematology analyser, serum vitamin B12 was quantified by enzyme-linked immunosorbent assay, and serum creatine kinase activity was measured on an automated chemistry analyser. Group comparisons were made using the independent-samples t-test and one-way analysis of variance, and relationships among variables were examined using Pearson correlation, with significance taken at p < 0.05.

Results: Packed cell volume (19.84 ± 4.52% versus 38.74 ± 2.45%), haemoglobin (6.52 ± 1.48 g/dL versus 14.72 ± 14.18 g/dL) and total white blood cell count (7,736 ± 3,406 versus 6,232 ± 1,744 cells/µL) differed significantly between patients and controls (p < 0.001 for each). Platelet count and the differential leukocyte counts were similar between the two groups (p > 0.05). Mean serum vitamin B12 (342.25 ± 463.36 pg/mL versus 445.60 ± 551.20 pg/mL, p = 0.258) and creatine kinase (169.32 ± 7.04 U/L versus 171.14 ± 6.41 U/L, p = 0.116) were comparable between the groups. Within the patient group, vitamin B12 correlated positively with lymphocyte percentage (r = 0.203, p = 0.042) and negatively with neutrophil percentage (r = -0.207, p = 0.039), while creatine kinase correlated negatively with basophil percentage (r = -0.261, p = 0.009). When patients were stratified into tertiles of vitamin B12 and creatine kinase, both markers showed graded, statistically significant associations with packed cell volume, haemoglobin, total white cell count, platelet count and differential leukocyte proportions (p < 0.05 for all).

Conclusion: Although mean serum vitamin B12 and creatine kinase levels were not significantly different between sickle cell patients and controls in this cohort, both markers showed consistent, graded relationships with haematological indices among patients, particularly with the immune cell components of the full blood count. Routine assessment of vitamin B12 and creatine kinase alongside the standard full blood count may support a more comprehensive evaluation of patients with sickle cell disease.

Evaluation of Some Inflammatory Markers of Malaria Infected Subjects in Port Harcourt, Nigeria

Sarah Ibinye Wilcox, Evelyn Mgbeoma Eze, Stella Urekweru Ken-Ezihuo — Mon, 07 Sep 2026 00:00:00 +0000

Malaria is a highly inflammatory disease characterised by periodic fever, headache, and nausea, which correspond to the rupture of infected erythrocytes and the release of merozoites that replicate within the host to produce newly formed daughter parasites. The aim of this study was to evaluate selected inflammatory markers in malaria-infected subjects in Port Harcourt, Nigeria. This study therefore sought to contribute to the prevention of complications arising from malaria parasitaemia. A cross-sectional case-control design was used. A total of 400 participants aged 1–65 years were included; 200 were positive for malaria parasites and 200 were negative. Ten millilitres of venous blood was collected from each subject. C-reactive protein (CRP) was analysed using an enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate (ESR) was analysed using the Westergren method, while plasma fibrinogen concentration was analysed quantitatively using the STA-Compact and Clauss clotting method. Malaria parasites were estimated by microscopy of thick and thin blood films stained with Giemsa. GraphPad Prism version 9.0.4 was used for data analysis. Mean CRP (52.09 ± 36.16), fibrinogen (514.80 ± 388.20), and ESR (39.41 ± 27.24) levels were significantly elevated in malaria-infected subjects compared with controls (5.94 ± 8.40, 247.50 ± 120.10, and 8.76 ± 3.84, respectively; P = .05). Significant differences were also identified between infected males (FIB 488.00 ± 18.75; ESR 35.31 ± 25.01) and infected females (FIB 541.52 ± 51.60; ESR 43.50 ± 28.82) at P = .05. These findings indicate sex-specific differences, particularly higher fibrinogen and ESR levels in females, suggesting a potentially more pronounced inflammatory response or altered haemostasis in women.

Leukocyte Differential Distribution and Creatine Kinase Elevations as Indicators of Tissue Stress and Inflammation in Sickle Cell Disease

Tue, 08 Sep 2026 00:00:00 +0000

Aims: To evaluate leukocyte subset distribution and serum creatine kinase (CK) activity, considered jointly, as indicators of tissue stress and low-grade inflammation in Nigerian patients with sickle cell anaemia.

Study Design: A hospital-based, cross-sectional comparative study.

Setting and Duration: Department of Haematology Laboratory, University College Hospital, Ibadan, Oyo State, Nigeria; data were collected over a twelve-month postgraduate research period (July 2025 to July 2026) as part of a wider investigation of this patient cohort.

Methodology: The analysis drew on 150 clinically stable, confirmed HbSS patients and 100 apparently healthy HbAA controls (N = 250), assembled as part of a larger parent study of this population. Total and five-part differential leukocyte counts were obtained on an automated haematology analyser, and serum CK activity was assayed by kinetic spectrophotometry on an automated chemistry analyser. The neutrophil-to-lymphocyte ratio (NLR) was derived from the differential count as a composite index of physiological stress. Between-group differences were tested using the independent-samples t-test and one-way analysis of variance across CK tertiles, and associations between CK and the differential leukocyte parameters were examined using Pearson correlation, with significance set at p < 0.05.

Results: Patients carried a significantly heavier total leukocyte load than controls (7,736 ± 3,406 versus 6,232 ± 1,744 cells/µL, p < 0.001), while the proportional differential counts and the derived NLR were closely similar between groups (NLR 0.99 versus 0.95), and mean CK did not differ significantly (169.32 ± 7.04 versus 171.14 ± 6.41 U/L, p = 0.116). Stratifying patients by CK tertile, however, uncovered a graded, dose-dependent shift: neutrophil percentage and NLR rose from 52.3% and 1.51 in the low tertile to 70.2% and 2.80 in the high tertile, lymphocyte percentage fell from 34.6% to 25.1% (all p ≤ 0.002), and CK correlated inversely with basophil percentage (r = -0.261, p = 0.009) but not with the other differential parameters.

Conclusion: A simple comparison against healthy controls masked what a within-patient, CK-stratified analysis revealed: a consistent, dose-dependent shift toward a neutrophil-predominant, lymphocyte-depleted leukocyte profile, mirrored by a rising NLR, as CK activity increased. Interpreting the leukocyte differential count and CK jointly, rather than each in isolation against reference values, may add practical value to the assessment of tissue stress and low-grade inflammation in sickle cell disease.

Oxidative Stress, Antioxidant Defense and Trace Element Alterations in Sickle Cell Disease during Vaso-Occlusive Crisis and Steady State

Sat, 19 Sep 2026 00:00:00 +0000

Background: Sickle cell disease (SCD) is associated with chronic haemolysis, inflammation and recurrent vaso-occlusive crises (VOC), with oxidative stress contributing to its pathophysiology. However, the interplay among oxidative stress, antioxidant defences and trace element status during steady state and VOC remains insufficiently characterised among Nigerian patients.

Aim: This study compared oxidative stress, antioxidant defence and selected trace element parameters in SCD patients during steady state and VOC.

Methodology: This comparative cross-sectional study involved 60 patients with confirmed SCD recruited at Babcock University Teaching Hospital, Ogun State, Nigeria. Participants were categorised into steady-state and crisis groups based on their clinical status. Serum vitamin C, vitamin E, zinc, iron, copper, magnesium, malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), thiamine pyrophosphate (TPP), glutathione peroxidase (GPx) and packed cell volume (PCV) were determined using standard methods. Data were analysed using Student’s t-test, Pearson’s correlation and binary logistic regression. Statistical significance was set at p < 0.05.

Results: Compared with the steady-state group, patients in crisis had significantly higher MDA, GPx, iron and copper levels, but significantly lower vitamin C levels (p < 0.05). PCV was significantly lower during crisis (17.0 ± 4.8% vs. 25.35 ± 1.9%; p < 0.001). PCV correlated negatively with MDA, GPx and copper and positively with vitamin C. In logistic regression, vitamin C and MDA were independently associated with crisis status.

Conclusion: VOC in SCD is associated with substantial alterations in oxidative stress and antioxidant responses, particularly increased lipid peroxidation and GPx activity alongside reduced vitamin C levels.

Prevalence of B-Thalassemia Trait among Individuals Undergoing Premarital Screening in Anbar Province

Mohammed Sabah Dawood, Rafi Khaleel Al-Ani, Ismail Khaleefah Nawaf — Wed, 23 Sep 2026 00:00:00 +0000

Background: β-thalassemia is a significant hereditary haematological disorder with a high prevalence in Iraq. Premarital screening is a critical preventive strategy for identifying couples at risk of having children with thalassemia major. This is the first study conducted in Anbar Province to evaluate the premarital screening programme.

Objectives: To determine the prevalence of β-thalassemia minor among individuals undergoing premarital investigations.

Material and Method: A retrospective record-based study was conducted among individuals undergoing premarital investigations at the premarital screening centres of the Anbar Health Directorate during 2025. Blood samples from each individual were analysed using a complete blood count (CBC), including haemoglobin concentration, mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH). Haemoglobin electrophoresis and quantification of HbA2 were also performed. Additional data included sex and place of residence.

Result: The prevalence of β-thalassemia trait was 0.82% among all screened individuals across Anbar centres. No statistically significant sex difference was observed. The highest number of cases was reported in Ramadi, whereas no positive cases were reported in Heet.

Conclusion: A low prevalence of β-thalassemia trait was observed among individuals undergoing premarital screening in Anbar Province. Annual surveillance is recommended. Further studies comparing the prevalence of β-thalassemia major before and after implementation of the national screening programme may help evaluate the programme's long-term preventive impact.

Chronic Haemolytic–inflammatory Activation Persists beyond Clinical Crisis in Adults with Sickle Cell Anaemia: A Comparative Cross-sectional Study

Thu, 01 Oct 2026 00:00:00 +0000

Background: Sickle cell anaemia is characterised by chronic haemolysis and inflammation. Whether these processes persist during clinically stable periods or are mainly associated with painful crises remains unclear in the local literature.

Objective: To compare lactate dehydrogenase (LDH) and C-reactive protein (CRP), markers of haemolysis and inflammation, among adults with sickle cell anaemia in steady state, those admitted with a painful crisis, and healthy controls.

Methods: This comparative cross-sectional study was conducted at the Haematology Day-care Unit, University College Hospital, Ibadan. The final analysed cohort comprised adults aged 18–67 years: 60 patients in steady state (ASS), 41 admitted with painful crisis (Bed), and 60 healthy haemoglobin AA controls (AHI), recruited by convenience sampling. Steady state was defined as at least three weeks without a painful crisis and three months without transfusion. Serum LDH was measured by a kinetic IFCC liquid, version 2 method on a Cobas c 111 clinical chemistry analyser (Roche Diagnostics), while CRP was measured by particle-enhanced immunoturbidimetry. Group comparisons used one-way ANOVA with Bonferroni post hoc testing and chi-square analysis; p<0.05 was considered significant.

Results: Mean LDH was 831.2±313.8 U/L in ASS, 811.4±246.2 U/L in Bed, and 165.7±36.6 U/L in AHI (F=154.645, p=0.0001). CRP was elevated in 86.7% of ASS and 97.6% of Bed participants, compared with none of the AHI group (χ²=128.705, p<0.001). LDH and CRP did not differ significantly between ASS and Bed groups (p=1.000 and p=0.090, respectively), but were significantly higher in both sickle cell groups than in AHI (p<0.001).

Conclusion: LDH and CRP were markedly elevated in adults with sickle cell anaemia during both steady state and painful crisis compared with healthy controls. The absence of a statistically significant difference between steady state and crisis does not establish equivalence, but indicates that substantial haemolytic and inflammatory activity was detectable during clinically stable periods. The findings require confirmation in longitudinal studies before routine biomarker monitoring is recommended.

Haematological and Peripheral Blood Smear Response to Two Months of Oral Iron Therapy in Anaemic Adult Females: A Paired Study from West Tripura, India

Anchal Saha, Suman Kalyan Nath, Prabal Krishna Majumder — Sat, 03 Oct 2026 00:00:00 +0000

Background: Anaemia is a common health problem among women of reproductive age. Local studies from Tripura have reported anaemia in young women and have highlighted the possible contribution of menstrual and nutritional factors. This study evaluated haematological parameters and peripheral blood smear findings in anaemic adult females before and after oral iron therapy.

Methods: This prospective paired study was conducted in West Tripura, India, from April to July 2026. Sixty anaemic adult females aged 20–45 years and 12 healthy female controls were evaluated. Fifteen of the 60 anaemic participants completed two months of prescribed oral iron therapy and underwent repeat testing; therefore, treatment-response analysis was restricted to these 15 participants. Haemoglobin, red blood cell count, packed cell volume, mean corpuscular volume, mean corpuscular haemoglobin, and mean corpuscular haemoglobin concentration were measured using an automated haematology analyser. Peripheral blood smears were stained with Leishman stain and examined microscopically. Ferritin/iron-profile investigations and reticulocyte counts were not performed.

Results: At baseline, anaemic participants had lower haemoglobin, red blood cell count, packed cell volume, and red cell indices than healthy controls. Among the 15 participants who completed follow-up, mean haemoglobin increased from 10.56 ± 0.31 g/dL to 12.37 ± 0.25 g/dL (p < 0.001). Red blood cell count, packed cell volume, mean corpuscular volume, and mean corpuscular haemoglobin also improved significantly. The change in mean corpuscular haemoglobin concentration was not statistically significant (p = 0.684). Peripheral blood smears showed qualitative improvement in red cell morphology after treatment. Because only 15 participants completed follow-up, these treatment-response findings are preliminary and should not be generalised to all 60 anaemic participants.

Conclusion: In the 15 anaemic participants who completed two months of follow-up, oral iron therapy was associated with significant improvement in most measured haematological parameters and qualitative improvement in peripheral smear morphology. The findings should be interpreted cautiously because of the small paired sample, substantial loss to follow-up, absence of biochemical iron studies and reticulocyte counts, incomplete information on the treatment regimen, and lack of an untreated comparison group.

Neurobehavioral and Hematological Effects of Zapoteca portoricensis (Jacq.) H.M.Hern Root Ethylacetate Fraction against Scopolamine Induced Cognitive Impairment in Rats

Fri, 09 Oct 2026 00:00:00 +0000

Background: Alzheimer’s disease (AD) is a neurodegenerative disorder characterised by progressive dementia, neuroinflammation, and the accumulation of intracellular neurofibrillary tangles and extracellular amyloid plaques. Oxidative stress and cholinergic dysfunction are key contributors to cognitive decline in AD.

Objective: This study evaluated the neuroprotective and haematological potential of the ethyl acetate fraction of Zapoteca portoricensis roots (ZP-EAF) in scopolamine-induced cognitive impairment and anaemia in Sprague Dawley rats.

Methods: Sprague Dawley rats were pre-treated with varying doses of ZP-EAF prior to scopolamine administration. Learning and memory were assessed using the Morris water maze (MWM). Brain levels of acetylcholinesterase (AChE) and malondialdehyde (MDA) were measured as markers of cholinergic activity and oxidative stress. Haematological indices, including packed cell volume (PCV), red blood cell count (RBC), haemoglobin (Hb), and mean cell volume (MCV), were monitored at 7-day intervals for 21 days.

Results: Scopolamine significantly increased AChE activity (9.04 ± 0.13 mol/min/g) compared with the normal control (5.84 ± 0.02). Donepezil reversed this effect (6.45 ± 0.23, p < 0.001). ZP-EAF produced a dose-dependent decrease in AChE, with the 200 mg/kg and 400 mg/kg groups showing supranormal levels of 4.01 ± 0.07 and 3.41 ± 0.26, respectively. Scopolamine also significantly increased MDA levels. While donepezil reduced MDA, ZP-EAF at 100 mg/kg showed superior antioxidant activity by lowering MDA below normal control levels. Higher doses (200 and 400 mg/kg) produced only partial reductions.

In the haematological study, ZP-EAF significantly (p < 0.001) increased PCV, RBC, and MCV in a non-dose-dependent manner compared with both the normal and positive controls.

Conclusion: ZP-EAF demonstrated neuroprotective effects by enhancing cholinergic activity and reducing oxidative stress, with the 100 mg/kg dose being most effective for antioxidant activity. Additionally, ZP-EAF exhibited significant haematinic potential by improving PCV, RBC, and MCV. These findings suggest that Zapoteca portoricensis may be a promising candidate for the management of cognitive impairment and anaemia.

Evaluation of Selected Hematological and Biochemical Parameters among Hypertensive Subjects Attending the Federal Medical Centre, Yenagoa, Nigeria

Ogechi Orluowhor, Benjamin Eledo, Richard Eze — Fri, 09 Oct 2026 00:00:00 +0000

Background: Hypertension is a major cardiovascular risk factor that may be associated with alterations in cardiac biomarkers, haematological parameters, lipid metabolism, vascular function, and inflammatory responses. Assessing haematological and biochemical parameters may therefore provide useful information about the systemic effects and possible complications of hypertension.

Aim: This study evaluated selected haematological and biochemical parameters among hypertensive subjects attending Federal Medical Centre, Yenagoa, Nigeria, and compared the findings with those of normotensive controls.

Materials and Methods: This comparative study included 100 participants: 50 hypertensive subjects and 50 normotensive controls. Each group included 20 males and 30 females, aged 20–50 years. We evaluated troponin I, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and haematological parameters using standard methods. GraphPad Prism was used for statistical analysis. We compared results between the two groups using an independent-samples t-test, with statistical significance set at p < 0.05.

Results: Troponin I concentration was significantly higher among hypertensive subjects than in controls. Total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol did not differ significantly between the groups. Similarly, haemoglobin concentration, packed cell volume, and RBC count did not differ significantly between hypertensive subjects and controls (p > 0.05). However, MCV, MCH, and MCHC were significantly higher among hypertensive subjects. Platelet count and total WBC count were also significantly higher in the hypertensive group (p = 0.001).

Conclusion: These findings highlight the value of combined haematological and biochemical assessment for evaluating and monitoring patients with hypertension. Such assessments may provide useful information on cardiovascular risk, haematological and metabolic alterations, and hypertension-associated factors.

C-Reactive Protein and Routine Coagulation Studies in Obstetric Patients with and without Recorded Clinical Complications in Ibadan, Nigeria

Thu, 15 Oct 2026 00:00:00 +0000

Background: Pregnancy alters inflammatory and haemostatic profiles, complicating the interpretation of routine laboratory measurements.

Aim: This study compared C-reactive protein (CRP), prothrombin time (PT) and activated partial thromboplastin time with kaolin (aPTTK) in obstetric participants with recorded clinical complications and apparently healthy pregnant controls in Ibadan, Nigeria.

Study Design: Comparative case-control study.

Place and Duration of Study: Adeoyo State Hospital, Ring Road, Ibadan, Oyo State, Nigeria. Data collection commenced in November 2025 following ethical approval and took place within the approved study period of 12 November 2025 to 11 November 2026.

Methodology: The study included 250 participants, 150 in the clinical group and 100 controls. The clinical group comprised participants with various obstetric and medical conditions. CRP was measured by latex-enhanced immunoturbidimetry on the Abbott ARCHITECT c4000. PT and aPTTK were measured by duplicate manual clot-endpoint procedures. CRP was compared using a Welch independent-samples t test, PT and aPTTK were compared using Mann-Whitney U tests, and associations were examined using Pearson product-moment correlation; analyses were unadjusted. Statistical significance was assessed at a two-sided alpha level of .05.

Results: Mean CRP was higher in the clinical group than in controls (3.71 ± 1.91 vs 2.87 ± 1.54 mg/L; P = .012; Cohen's d = 0.45). PT did not differ significantly between groups (median 12.95 vs 12.78 s; P = .312), and aPTTK was also similar (median 29.96 vs 30.41 s; P = .590). CRP correlated weakly and inversely with PT (r = -0.24, P = .001) and aPTTK (r = -0.21, P = .006), while PT and aPTTK were weakly positively correlated (r = 0.15, P = .047).

Conclusion: The clinical group had a higher mean CRP concentration, while routine coagulation studies did not differ significantly. Correlations were weak. Given the heterogeneous clinical group and unadjusted comparisons, findings represent aggregate rather than condition-specific associations.

Total and Differential White Blood Cell Counts among Women Using Oral Contraceptives in Owerri, Southeastern Nigeria: A Comparative Cross-sectional Study

O. Nwaiwu Divine, Aloy-Amadi Oluchi Chinwe, Tamunonengiye-Ofori Lenox-Prince — Fri, 16 Oct 2026 00:00:00 +0000

Background: Oral contraceptives are widely used for family planning, yet their relationship with circulating leukocyte patterns is not fully understood and may differ according to population and hormonal formulation.
Objective: To compare total and differential white blood cell counts in women using oral contraceptives with those of healthy non-users in Owerri, Imo State, Nigeria.

Methods: This comparative cross-sectional study involved 100 women aged 18-45 years, comprising 50 regular oral-contraceptive users and 50 non-users. Five millilitres of venous blood were collected into ethylenediaminetetraacetic acid containers. Total white blood cell count was measured using an automated haematology analyser, while differential leukocyte percentages were determined from Leishman-stained blood films after 100 leukocytes had been classified. Data were analysed using descriptive statistics, the independent-samples t-test and Pearson correlation. Statistical significance was set at p<0.05.

Results: Mean total white blood cell count was lower among users than controls (4.89 +/- 1.61 vs. 7.60 +/- 1.22 x 10^9/L; p<0.0001). Users had a higher neutrophil percentage (55.80 +/- 8.13% vs. 35.62 +/- 9.32%; p<0.0001), but lower lymphocyte (35.66 +/- 8.76% vs. 55.26 +/- 9.57%; p<0.0001) and monocyte percentages (5.18 +/- 1.61% vs. 7.28 +/- 2.68%; p<0.0001). Eosinophil and basophil percentages were also higher among users (p=0.0381 and p<0.0002, respectively). Age was not significantly correlated with any measured leukocyte parameter among users.

Conclusion: Oral-contraceptive use was associated with a lower total white blood cell count and a different relative distribution of leukocytes in this study population. The cross-sectional design and use of percentage differentials, however, do not permit causal or functional interpretation. Larger longitudinal studies that account for contraceptive formulation, duration of use, absolute differential counts and relevant confounders are needed.

Awareness, Risk Factors and Prevalence of Viral Hepatitis B and C among Antenatal Attendees in Federal Medical Centre, Asaba: A Cross-sectional Study

Sat, 24 Oct 2026 00:00:00 +0000

Aim: To evaluate the level of awareness, risk factors, and prevalence of viral hepatitis B and C among antenatal attendees at Federal Medical Centre, Asaba.

Place and Duration of Study: Federal Medical Centre, Asaba, Delta State, from June to October 2025.

Methodology: This hospital-based descriptive cross-sectional study involved 145 pregnant women attending the antenatal clinic at Federal Medical Centre, Asaba, from June to October 2025. Ethical approval was obtained before the commencement of the study, and informed consent was secured from all participants prior to enrolment. Data on participants’ sociodemographic characteristics, level of awareness, knowledge, and possible risk factors associated with hepatitis B and C infection were collected using a pretested structured questionnaire. Approximately 3 mL of venous blood was collected aseptically from each participant and analysed for hepatitis B surface antigen (HBsAg) and hepatitis C virus antibodies using standard rapid diagnostic test kits. The data obtained were analysed using IBM SPSS Statistics, with both descriptive and inferential statistical methods applied. Statistical significance was set at p ≤ 0.05.

Results: Of the 145 pregnant women who attended the antenatal clinic, most were between 21 and 30 years old (72.4%), and almost all were married (96.6%). Awareness of hepatitis B was relatively high, with about three-quarters of participants having heard of it (75.2%), while awareness of hepatitis C was lower (58.6%). Overall, participants demonstrated a moderate understanding of how these infections are transmitted (52.4%). Healthcare professionals were the most commonly reported source of information on viral hepatitis (46.9%). Although a large proportion of the women acknowledged the importance of hepatitis B vaccination (77.9%), only a small number had received the vaccine (13.1%). Screening results showed that 2.8% of the participants tested positive for hepatitis B, while none tested positive for hepatitis C.

Conclusion: The findings indicate that although awareness of viral hepatitis among pregnant women was fairly encouraging, the low uptake of hepatitis B vaccination remains a major concern. This highlights the need for stronger health education during antenatal visits, regular screening, and improved preventive measures to reduce the burden of hepatitis infections among pregnant women.

Effect of Anticoagulant Therapy on Platelet Function Parameters in Blood Transfusion Recipients at the University of Uyo Teaching Hospital, Nigeria

Edua Eddy Ofose , Ransom Baribefe Jacob, Zacchaeus Awortu Jeremiah — Thu, 29 Oct 2026 00:00:00 +0000

Background: Anticoagulant therapy is widely used for the prevention and management of thromboembolic disorders, but its effects on platelet-related and coagulation parameters require appropriate laboratory monitoring to support safe and effective treatment.

Aim: This study assessed selected platelet function-related, haematological and coagulation parameters among patients receiving anticoagulant therapy at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.

Methods: A cross-sectional comparative study was conducted among 92 participants, comprising 46 patients receiving anticoagulant therapy and 46 apparently healthy controls. Seven millilitres (7.0 mL) of venous blood were collected from each participant for full blood count estimation using the Sicuro HEMIA 5D automated haematology analyser and coagulation profile analysis. Reagents from Agappe Diagnostics Ltd. were used for the determination of Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT) and fibrinogen concentration in samples using a manual clot-based method. The INR was calculated from PT values using the International Sensitivity Index (ISI), fibrinogen concentration was measured using the Clauss clotting method, while D-dimer concentration was measured using a fluorescence immunoassay (FIA) method with reagents from Boditech Med/iChroma Ltd. Statistical analysis was performed using IBM SPSS Statistics Version 32.0.0. Continuous variables were presented as means ± standard deviations and medians, where appropriate. Between-group comparisons were performed using Welch's independent-samples t-test (two-sided, α=0.05). Pearson correlation was used to assess associations of laboratory parameters with age and duration of anticoagulant therapy within the anticoagulant group. Sex-stratified comparisons used Welch's t-test.

Results: The platelet count in the anticoagulant group, 220.26 ± 58.81x 10^9/L was significantly lower than the platelet count in controls of 255.54 ± 104.55 x 10^9/L (t=1.994; p=0.004). A similar pattern was observed for plateletcrit and PDW. MPV did not differ significantly between groups. On the other hand, the anticoagulant group demonstrated significantly prolonged PT (19.87 ± 4.63s vs 12.47 ± 0.61s respectively), aPTT (36.48 ± 5.12s vs 30.56 ± 2.77s respectively), and a higher INR (1.72 ± 0.57) compared with controls (1.07 ± 0.10) (p < 0.0001). D-dimer was significantly higher among participants receiving anticoagulants (430.43 ± 94.52 ng/mL vs 257.61 ± 72.55 ng/mL) (p < 0.0001). Fibrinogen concentrations did not differ significantly between groups. Significant differences were also observed in MCV, MCH, neutrophil, lymphocyte and basophil percentages. The duration of anticoagulant therapy showed significant associations with WBC, RBC, haemoglobin and haematocrit.

Conclusion: These findings demonstrate that patients receiving anticoagulant therapy had significant alterations in haematological and coagulation parameters compared with controls, highlighting the importance of comprehensive laboratory monitoring to assess haemostatic status during anticoagulant therapy.

Haematological Alterations According to Treatment Status among Nigerian Women with Breast Cancer

Thu, 29 Oct 2026 00:00:00 +0000

Background: Breast cancer and its treatment may alter erythropoiesis, leukocyte distribution and platelet characteristics. Evidence describing these changes among Nigerian women remains limited, particularly in studies that distinguish newly diagnosed patients from treatment-exposed patients.

Aim: To determine haematological alterations according to treatment status among Nigerian women with breast cancer.

Materials and Methods: This case-control study analysed 120 women in Port Harcourt, Nigeria: 40 treatment-exposed breast cancer patients, 40 newly diagnosed treatment-naive breast cancer patients and 40 apparently healthy controls. EDTA-anticoagulated whole blood was analysed using an automated haematology analyser. Results were summarised as mean ± standard error of the mean (SEM). Full blood count, differential leukocyte parameters and platelet indices were compared using one-way analysis of variance (ANOVA). Significant omnibus results were followed by Tukey’s honestly significant difference comparisons. Statistical significance was set at p < 0.05.

Results: Treatment-exposed patients had lower mean haemoglobin (11.04 ± 0.39 g/dL) than newly diagnosed patients (11.56 ± 0.26 g/dL) and controls (11.69 ± 0.13 g/dL; F = 10.7118, p < 0.0001). Significant group differences also occurred in MCV (F = 6.5726, p = 0.0020), MCH (F = 15.0127, p < 0.0001), MCHC (F = 13.7059, p < 0.0001), RDW-CV (F = 30.2256, p < 0.0001) and RDW-SD (F = 25.1891, p < 0.0001). Treatment-exposed patients had the highest neutrophil percentage (63.70 ± 2.32%; F = 22.8691, p < 0.0001) and lowest lymphocyte percentage (27.70 ± 2.30%; F = 34.1758, p < 0.0001). Monocyte percentage differed across groups (F = 6.0390, p = 0.0032); between-group tests for basophil percentage were not reported. Platelet count was similar across groups (F = 0.2378, p = 0.7887), whereas PDW differed significantly (F = 12.5106, p < 0.0001). The reported group superscripts identify differences involving treatment-exposed patients for several erythrocyte and leukocyte measures.

Conclusion: Treatment-exposed women demonstrated the most pronounced erythrocyte and leukocyte-distribution abnormalities. The findings support routine full blood count monitoring before and during breast cancer treatment, but the cross-sectional design does not establish that treatment caused the abnormalities.

Haematological Parameters of Patients with Suspected Cases of Malaria in General Hospital Doma, Nasarawa South, Nigeria

Danjuma J., S. P. Akpulu, S. C. Tama, P. A. Odeh, M. M. Jakonda, I. H. Nkene — Sat, 31 Oct 2026 00:00:00 +0000

Background: Malaria is associated with changes in haematological indices, but local evidence among patients presenting with suspected malaria at General Hospital Doma, Nasarawa South, Nigeria, remains limited. This study assessed malaria prevalence and compared haematological parameters according to infection status.

Methods: A descriptive cross-sectional study was conducted between January and June 2026. Venous blood samples were obtained from 325 eligible patients with suspected malaria. Infection was investigated using microscopy and a rapid diagnostic test, and haematological indices were measured using an automated analyser. Age- and sex-specific prevalence was examined using chi-square tests, while Welch’s t-test was used to compare haematological parameters between infected and non-infected patients.

Results: Malaria was detected in 84 patients (25.8%). Prevalence was highest among those aged 31–40 years (34.0%), but the association with age was not statistically significant (P = 0.2972). Prevalence was 30.9% in males and 21.4% in females (P = 0.0501). Compared with non-infected patients, infected patients had lower mean platelet counts (172.72 versus 230.46 × 10⁹/L), total white blood cell counts (6.40 versus 7.75 × 10⁹/L), lymphocyte percentages, mean corpuscular volume and mean corpuscular haemoglobin. RDW-CV and eosinophil percentages were higher in infected patients. Packed cell volume and the remaining reported indices did not differ significantly.

Conclusion: Malaria was identified in approximately one-quarter of patients with suspected infection. Several haematological indices differed between groups and may provide supplementary clinical information, although they cannot replace parasitological confirmation.

Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio among Pregnant Women with and without Pre-Eclampsia

Thu, 05 Nov 2026 00:00:00 +0000

Background: Pre-eclampsia is associated with maternal inflammatory and haematological changes. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are accessible indices derived from a routine complete blood count.

Objective: To compare NLR, PLR, and selected blood-cell parameters in pregnant women with and without pre-eclampsia at a tertiary hospital in Nigeria.

Methods: In this hospital-based comparative cross-sectional study, 366 pregnant women (183 with pre-eclampsia and 183 normotensive controls) were recruited consecutively. NLR and PLR were calculated from full blood counts. Analyses included group comparisons, correlations and exploratory logistic regression.

Results: NLR was higher in the pre-eclampsia group (4.27 ± 1.32 vs. 2.79 ± 0.90; p < .001; mean difference, 1.48; approximate 95% CI [1.25, 1.71]), whereas PLR did not differ significantly (115.37 ± 40.78 vs. 121.47 ± 33.97; p = .121). Neutrophil and total white blood cell counts were higher, whereas lymphocyte and platelet counts were lower, in women with pre-eclampsia. Across the pooled sample, NLR correlated with systolic (rₛ = .456) and diastolic (rₛ = .463) blood pressure. Adjusted models were exploratory because of mathematically linked predictors and an undefined ANC-labelled covariate.

Conclusion: NLR was higher among pregnant women with established pre-eclampsia in this tertiary-care sample, whereas unadjusted PLR values did not differ significantly. These cross-sectional associations do not establish independent diagnostic accuracy, future disease prediction or causal effects.

Evaluation of Haemostatic and Inflammatory Parameters in Treatment-Naïve and Non-Naïve HIV-Positive Subjects: Demographic Characteristics and Exploratory Analysis by Marital Status

I. Okon, Betini, I. Eze, Richard, Eledo, Benjamin — Thu, 05 Nov 2026 00:00:00 +0000

Aims: This study evaluated and compared prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) among treatment-naïve HIV-positive subjects, non-naïve HIV-positive subjects and HIV-negative controls, and explored these parameters in relation to marital status.

Study Design: A cross-sectional comparative study.

Methodology: One hundred and fifty adults aged 20–60 years were recruited from clinical and community sources. They comprised 35 treatment-naïve HIV-positive subjects, 50 non-naïve HIV-positive subjects who had received first-line antiretroviral therapy, mainly tenofovir/lamivudine/dolutegravir, for at least six months, and 65 apparently healthy HIV-negative controls. PT and APTT were determined manually, fibrinogen was measured by the Clauss method using an STA-Compact coagulation analyser, and IL-6 and TNF-α were measured by sandwich ELISA. Overall group summaries were reconciled from the reported marital-status subgroup counts, means and standard deviations. One-way ANOVA and Bonferroni-adjusted pairwise comparisons were applied.

Results: After internal reconciliation, significant overall group differences were present for PT (F = 70.327, p < 0.001), fibrinogen (F = 566.548, p < 0.001), IL-6 (F = 468.598, p < 0.001) and TNF-α (F = 441.026, p < 0.001), but not APTT (F = 2.494, p = 0.086). For PT, fibrinogen, IL-6 and TNF-α, all three group pairs differed after Bonferroni adjustment (all adjusted p < 0.001). No APTT pairwise comparison was significant. The marital-status analysis was exploratory; an unadjusted group-by-marital-status interaction was detected for fibrinogen (F = 4.516, p = 0.013) but not for PT, APTT, IL-6 or TNF-α.

Conclusion: The three study groups differed in PT, fibrinogen, IL-6 and TNF-α, whereas the reconciled APTT analysis did not show a statistically significant group difference. Because this was a cross-sectional comparison of distinct participants, the observed differences cannot be attributed causally to antiretroviral therapy. The marital-status findings do not establish independence from, or modification by, marital status and require confirmation in adequately powered analyses with relevant clinical covariates.

Haematological Inflammatory Indices and Cardiometabolic Risk Indicators in Young Apparently Healthy Adults in Port Harcourt, Nigeria: A Cross-Sectional Study with Limited Predictive Utility

Beauty Eruchi Echonwere-Uwikor, Erens Spiff Ekprikpo, Chiemeka Cynthia Ifunanya — Thu, 12 Nov 2026 00:00:00 +0000

Background: Haematological inflammatory indices (NLR, PLR and SII) have been proposed as cardiometabolic risk markers, but data on young Africans are limited, and predictive claims are often overstated.

Aim: This study examined associations of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) with cardiometabolic indicators and assessed the feasibility of composite-risk prediction.

Methods: This was a secondary analysis of de-identified data from 100 apparently healthy adults in Port Harcourt (ethical approval for secondary analysis: RSHMB/RSHREC/2026/120, dated 22 July 2026). NLR, PLR and SII were calculated from complete blood counts. Cardiometabolic indicators included BMI, waist circumference, WHR, SBP, DBP, fasting glucose, TC, TG, HDL-C and LDL-C. Risk-component burden was the count of harmonised components. Associations were assessed using Spearman’s ρ because of skewed indices. The feasibility of ROC analysis and logistic regression was assessed.

Results: No participant met the composite MetS proxy (0/99). Isolated abnormalities included elevated WHR (38.4%), abdominal obesity (22.2%) and elevated BP (20.0%). NLR showed a weak positive correlation with glucose (ρ=0.23, p=0.017) and a weak negative correlation with SBP (ρ=-0.20, p=0.048). PLR showed no significant correlations (ρ -0.15 to 0.15, all p>0.05). SII showed no significant correlations; the association with HDL-C was ρ=0.19, p=0.060. None of the indices correlated significantly with risk-component burden: NLR ρ=0.11 p=0.293, PLR ρ=-0.04 p=0.677, SII ρ=0.04 p=0.675. Binary prediction was not estimable because there were no cases.

Conclusions: In this young, low-risk cohort, NLR, PLR and SII showed limited associations with cardiometabolic indicators and did not track risk-component burden. The NLR–glucose association warrants replication. These indices should not be used as standalone predictors of composite risk in low-risk youth; they may serve as adjunct markers pending evaluation in larger, more diverse cohorts.

Marked Differences in Haematological Parameters between Plasmodium falciparum/Plasmodium vivax Co-infection and Plasmodium falciparum Mono-infection in Bamenda, Northwest Cameroon

Fri, 13 Nov 2026 00:00:00 +0000

Aim: This study evaluated variations in haematological parameters and indices by malaria infection status and species in Bamenda, Northwest Cameroon.

Study Design: This was a hospital- and community-based cross-sectional survey.

Place and Duration of Study: The study was conducted in the Bamenda I, II, and III Health Districts as part of a study on the epidemiology of malaria conducted from January to September 2024.

Methodology: Using convenience sampling, 1,133 consenting participants were recruited from individuals referred to health-facility laboratories for malaria parasite (MP) diagnosis and from residents of the study communities. Blood specimens were collected, and thick and thin blood smears were prepared, stained with Giemsa, and examined microscopically for the detection and speciation of MP, respectively. Full blood counts (FBCs) were analysed using the haematology analyzer (REGO, S/N: S1-2207067, P/S: AC220V,50Hz, M/D: 7/2022). Data were analysed using SPSS version 28.0.

Results: The overall prevalence of MP was 16.2% (183/1133), with Plasmodium falciparum being predominant (14.5%; 164/1133). Plasmodium vivax occurred as mono- (0.2%; 02/1133) and co-infections (1.5%; 17/1133). MP-positive participants had a higher mean ± SD white blood cell (WBC) count (5381±4510 /µl) than MP-negative participants (4807±3160 /µl) with the difference approaching statistical significance (F=3.7, P =.05). RBC counts were similar in positive (4429620±1271892 /µl) and negative participants (4271578±1109049 /µ, F=2.5, P =.11). The highest mean ± SD WBC count (6705±10992 /µl) occurred in P. falciparum and P. vivax (Pf/Pv) co-infections. Lower mixed cell counts (MID), neutrophil counts, and platelet distribution widths (PDW) were recorded in malaria-infected individuals. Species-specific comparisons showed lower levels of MID, neutrophils, and PLCR, but higher WBC counts in P. falciparum/P. vivax co-infections.

Conclusion: Integrating platelet counts and indices with RBC and WBC counts and indices in malaria assessment may support parasite species diagnosis and management.

Full Blood Count Platelet Parameters in Sickle Cell Disease: A Systematic Review of Thrombocytosis, Thrombocytopenia, and Clinical Implications

Sat, 25 Jul 2026 00:00:00 +0000

Background: Sickle cell disease (SCD) is characterized by chronic hemolysis, endothelial dysfunction, and systemic inflammation, each of which disrupts platelet homeostasis. The full blood count (FBC), the most universally available hematological test, remains underutilized in routine clinical interpretation of thrombocytosis and thrombocytopenia in SCD. Both abnormalities contribute to the hypercoagulable phenotype and organ complications of SCD; however, their prevalence, causes, and prognostic significance vary by genotype, clinical state, and geography.

Objective: To evaluate the utility of the FBC in detecting, understanding, and managing platelet abnormalities in SCD by synthesizing 2020–2026 evidence on prevalence, etiology, pathophysiology, clinical implications, complications, and management strategies.

Methods: This systematic review followed PRISMA 2020 guidelines. Ten databases were searched from 1 January 2020 to 31 March 2026; searches were executed on 2 April 2026 and updated on 10 April 2026. Of 680 records retrieved, 56 duplicates were removed, yielding 624 unique records; 550 underwent full-text assessment. Sixty-three studies met all inclusion criteria. Prevalence data were pooled using random-effects meta-analysis; publication bias was assessed using Egger’s and Begg’s tests, with trim-and-fill correction applied where asymmetry was detected.

Results: Observed prevalence of thrombocytosis was 30.9% (95% CI: 26.4–35.7%) at steady state and 66.1% (95% CI: 61.3–70.6%) during acute events; trim-and-fill-adjusted steady-state estimates were 28.4% (95% CI: 24.1–33.0%) for thrombocytosis and 19.1% (95% CI: 15.6–23.2%) for complication-associated thrombocytopenia. Substantial between-study heterogeneity was observed across all outcomes (I² range: 68.3–82.4%). Thrombocytopenia occurred in 7.4% (95% CI: 5.9–9.2%) at steady state and 22.0% during complications. Thrombocytosis was predominantly reactive, driven by functional asplenia, haemolysis-induced thrombopoietin release, iron deficiency, and inflammatory cytokines. Thrombocytopenia reflected acute pathology including splenic sequestration, thrombotic microangiopathy, sepsis, and aplastic crisis. A multi-center cohort study of SCD patients in Oman (Alkindi et al., 2024) identified a rapid decline in platelet count as a significant correlate of mortality, alongside leukocytosis and elevated haemolytic markers, with thrombocytopenia preceding multiorgan failure in non-survivors.

Conclusions: The FBC is a high-yield, low-cost diagnostic and prognostic tool in SCD. Integrating platelet count, MPV, and PLR with clinical context and hematological markers may improve risk stratification, though prospective validation of specific thresholds for MPV and PLR in SCD is still required. Management should be etiology-specific, with platelet transfusion reserved for life-threatening hemorrhage. Standardizing FBC interpretation through simple, resource-appropriate algorithms can enhance early complication detection, particularly in low-resource, high-burden settings.

Broken Trephine Biopsy Needle: A Case Report of a Rare but Not Impossible Complication

Thu, 28 May 2026 00:00:00 +0000

Background: Bone marrow aspiration and trephine biopsy are essential procedures in haematology for the diagnosis, prognostication, and monitoring of a wide range of haematological disorders. Although generally safe, rare procedural complications may occur, including breakage of the biopsy needle.

Case Presentation: We report the case of a 67-year-old man with recurrent transfusion-dependent anaemia and neutropenia who underwent bone marrow aspiration and trephine biopsy as part of his diagnostic evaluation. During the trephine biopsy procedure, the biopsy needle fractured while being manipulated for core retrieval, leaving an approximately 3 cm fragment lodged within the posterior ilium. Radiographic imaging confirmed the retained fragment. Following multidisciplinary assessment, the patient underwent successful surgical extraction of the needle fragment by orthopaedic surgeons under local anaesthesia with monitored anaesthetic care. The postoperative course was uneventful, and the patient was discharged with appropriate follow-up.

Discussion: Needle fracture during bone marrow biopsy is an exceptionally uncommon complication, with only a limited number of cases reported in the literature. Factors that may contribute to its occurrence include patient movement, inadequate analgesia or sedation, operator-related technical challenges, and compromised needle integrity. Prompt recognition, radiological localisation, and multidisciplinary management are essential to minimise morbidity.

Conclusion: Broken trephine biopsy needles represent a rare but significant complication of bone marrow biopsy procedures. Awareness of this possibility, careful procedural technique, adequate patient comfort measures, and assessment of equipment integrity are important for prevention. Reporting such cases contributes to improved recognition and management of this unusual event.

Triple-negative Primary Myelofibrosis: A Diagnostic Challenge

J. Sakthivel, P. Dineshkumar, V. Prabhu, M. Lavanya, T. B. Uma Devi — Tue, 30 Jun 2026 00:00:00 +0000

Primary myelofibrosis (PMF) is a BCR-ABL1-negative myeloproliferative neoplasm that may be diagnostically difficult when canonical driver mutations are absent. We report a male in his 30s with treated hypothyroidism who presented with low-grade intermittent fever and left-sided dragging abdominal pain for one week, with loss of appetite for two months, weight loss for one month and easy fatigability for one month. Examination showed pallor and massive splenomegaly extending beyond the umbilicus into the right iliac fossa. Complete blood count demonstrated pancytopenia, with haemoglobin 5.6 g/dL, total count 1.1 x 10^3/microL and platelet count 55 x 10^3/microL. Peripheral smear showed dimorphic anaemia, nucleated red blood cells, leucopenia, thrombocytopenia and a leucoerythroblastic blood picture, without circulating blasts or dysplastic cells. Imaging confirmed massive splenomegaly without lymphadenopathy. Bone marrow biopsy showed hypercellular marrow with trilineage haematopoiesis, dimorphic erythropoiesis, megakaryocytic atypia with hypolobulated and dwarf forms, and grade 2 marrow fibrosis. BCR-ABL1 fluorescence in situ hybridisation was negative, and JAK2, CALR and MPL testing did not identify clinically significant variants. Positron emission tomography-computed tomography, flow cytometry, autoimmune tests, viral serology and infectious work-up did not support lymphoma or reactive marrow fibrosis. Next-generation sequencing did not detect high-risk or prognostically adverse mutations. On clinicopathological correlation, the diagnosis favoured triple-negative overt fibrotic PMF. The patient was risk stratified as clinically intermediate risk and treated with ruxolitinib and thalidomide, with improvement in cytopenias, constitutional symptoms and spleen size. The case highlights the importance of integrating marrow morphology, exclusion of secondary causes and molecular testing in triple-negative PMF.

Transfusion Therapy in Autoimmune Hemolytic Anemia Patient: A Case Report

Samaira Rawat, Ashish Jain — Sat, 18 Jul 2026 00:00:00 +0000

Background: Autoimmune haemolytic anaemia (AIHA) is a relatively uncommon form of haemolytic anaemia characterised by the presence of autoantibodies directed against erythrocyte surface antigens, most frequently of the IgG isotype. A positive direct antiglobulin test (DAT) is a key diagnostic criterion for AIHA. However, when haemolysis involves multiple autoantibodies, the standard DAT (polyspecific, anti-IgG + C3) may fail to detect certain antibodies, potentially delaying appropriate treatment.

Case Presentation: We report a patient with severe AIHA mediated by IgG and IgA autoantibodies. A 1-day-old term baby was admitted to the neonatal ICU with chief complaints/diagnoses of biliary atresia with acute biliary encephalopathy, neonatal hepatitis, congenital hydrocele, Rh incompatibility, respiratory failure, seizures and shock. The maternal blood group was AB negative, and the neonatal blood group was AB positive. The neonate presented with a history of abdominal distension, hypoalbuminaemia, sepsis, yellowish discoloration of the skin and moderate thrombocytopenia. Radiological findings, including ultrasonography of the abdomen and pelvis, showed hepatosplenomegaly, cystitis, mild ascites and multiple fluid-filled bowel loops; the neurosonogram showed no significant finding. The direct Coombs test showed IgG positivity and C3d negativity, and the indirect Coombs test was positive.

Conclusions: Extended direct antiglobulin test (DAT) evaluation is recommended for all patients presenting with clinical manifestations and laboratory evidence of acute haemolysis. Early identification facilitates prompt diagnosis, minimises the need for unnecessary additional investigations, and enables timely and effective clinical management. Severe autoimmune haemolytic anaemia (AIHA) mediated by multiple autoantibodies necessitates the early initiation of intensive combination therapy, incorporating immunosuppressive agents, intravenous immunoglobulin (IVIG), and plasma exchange.

Bilateral Peripheral Ulcerative Keratitis with Corneal Perforation Revealing Acute Myeloid Leukaemia in a Young Adult: A Case Report

Lotfi Chaabani, Ines Bouallegui, Mohamed Said, Yosra Hamdi — Thu, 13 Aug 2026 00:00:00 +0000

Background: Peripheral ulcerative keratitis (PUK) is a destructive corneal disorder that may progress rapidly to perforation and can occasionally indicate serious systemic disease.

Aim: To report a rare and clinically important case of bilateral peripheral ulcerative keratitis (PUK), complicated by unilateral corneal perforation, as the initial ophthalmic presentation that led to the diagnosis of acute myeloid leukaemia (AML) in a young adult.

Presentation of Case: A 31-year-old man with no previous ocular or systemic history presented with severe asthenia, dyspnoea, diffuse arthromyalgia, and bilateral ocular pain, redness, tearing, photophobia and decreased vision of approximately three weeks' duration. Best-corrected visual acuity was counting fingers in the right eye and light perception in the left eye. Slit-lamp examination showed bilateral conjunctival hyperaemia, palpebral conjunctival fibrosis, a superior temporal peripheral corneal ulcer in the right eye, and an inferior temporal corneal perforation sealed by iris tissue in the left eye. Microbiological and autoimmune investigations were non-contributory. Haematological assessment, followed by bone marrow examination, confirmed AML. Detailed AML subtype-defining investigations, the coagulation profile, and complete treatment-outcome data were not available in the ophthalmic record and are acknowledged as limitations. Multidisciplinary management included ocular surface stabilisation, planned tectonic corneal surgery, and systemic antileukaemic treatment. The patient died before completion of treatment.

Discussion: PUK is usually immune-mediated or infectious, but it may rarely reveal an occult haematological malignancy. In this patient, bilateral, rapidly progressive PUK with corneal perforation, systemic symptoms, negative microbiology and non-contributory autoimmune testing supported a clinical association with AML after exclusion of more common causes. Potential mechanisms include immune-mediated stromal melt, paraneoplastic inflammation, leukostasis-related microvascular injury and AML-associated coagulopathy, although direct ocular tissue infiltration, hyperleukocytosis and disseminated intravascular coagulation were not documented.

Conclusion: Severe, bilateral, or perforating PUK should prompt urgent systemic assessment, including complete blood count and haematological evaluation. Early recognition is important because this ocular emergency may reveal a life-threatening systemic disease requiring immediate multidisciplinary management.