Hematology Papers & Publications

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Anemia, iron deficiency and iron deficiency anemia are common blood disorders. The role of vitamin D was agreed to be regulating in calcium and phosphate absorption and bone metabolism and its deficiency is observed as a crucial nutritional problem. Vitamin D is created under the skin by ultraviolet light. It is usually get vitamins from the food; however, in the case of vitamin D, there simply are not enough rich food sources for people to get adequate amounts in their diet. Its effects on the prevention of diseases such as cardiovascular disease and anemia has received much attention recently. To get sufficient vitamin D, need to be exposed to sunshine or use supplements. Vitamin D3 was found in the largest population as a deficiency. With regard to hemoglobin was the subject whom has less normal range of hemoglobin (19.05%) than international normal range, and in ferritin the low population number was the subject whom has less normal range of ferritin than WHO normal range. The population who has low ferritin also has low vitamin D3 and variable hemoglobin. According international guidelines, optimizing nutrition with daily or intermittent (1 to 3 times per week) iron supplementation, should be considered a first-line intervention in high-risk or high-prevalence groups. Although it is probably less effective than daily iron supplementation, intermittent iron appears to be a useful and cost effective way of controlling anemia and iron deficiency anemia. This may indicate that a positive relation between the low concentration parameter of vitamin D3 and ferritin level but no significant correlation with hemoglobin.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

ABSTRACT Background: One of the many functions of the liver is the synthesis of carrier proteins and hormone metabolism, and liver diseases have been linked to a variety of endocrine disorders. Aim:The study's goal was to look at the spectrum of chronic liver disease and the relationship between thyroid profile and severity of liver damage in a tertiary hospital. Methods and materials: The current study was a single-center, tertiary care hospital-based,case-control study that included 50 cases of liver cirrhosis/chronic liver disease and 50 age/sex matched healthy controls (chosen at random from relatives attending OPD with patients). Thyroid function tests were performed and results were compared between cases and controls.Result : This study included 50 cases of liver cirrhosis/chronic liver disease and 50 healthy controls.The mean age and gender of cases and controls were comparable, and the difference was not statistically significant. The majority of cases (76%) had alcoholic liver cirrhosis, with the remainder having non-alcoholic liver cirrhosis (16%) and chronic viral hepatitis (8%). As per Child-Pugh Score, the majority of cases (40%), followed by Child-Pugh C (32%) and Child-Pugh A (28%). In the current study, free T3, free T4, and TSH levels were compared between cases and controls, and abnormal values were found in cases, indicating a statistically significant difference. Serum thyroid profile abnormalities were observed as Child-Pugh Score Classes advanced, and the difference was statistically significant for free T3 and free T4. Conclusion: As compared to healthy subjects, patients with liver cirrhosis had abnormally high levels of circulating thyroid hormone, and severe abnormalitieswere linked to an advanced Child Pugh score. Derangement in thyroid profile is common in patients with cirrhosis of liver. Low free T3 and T4 levels are associated with more severe liver injury and may be used for prognostication in patients with cirrhosis of liver. Keywords: chronic liver disease; NAFLD, cirrhosis, Liver function tests; Free T3 and T4; TSH;

Tapas Tripathi

Venous thromboembolism (VTE) is a serious medical condition that has a high clinical burden on both the mother and fetus, despite having a low incidence during pregnancy and the postpartum period. VTE is a leading cause of death among pregnant women and new mothers worldwide, and its severity cannot be underestimated. The development of VTE is influenced by a combination of genetic and environmental factors, as well as acquired conditions. Pregnancy-related changes, such as increased levels of coagulation factors and diminished fibrinolysis, can increase the risk of VTE. Additionally, older mothers, those who are obese, multiparous, or have undergone cesarean delivery, are at a higher risk of developing VTE. Owing to the lack of standardized guidelines and reliable data on VTE prevention, diagnosis, and treatment, authorities have developed risk scores that allow for a personalized assessment of the risk of thrombosis during pregnancy and postpartum, enabling a tailored approach to prevent thrombosis. Managing VTE during pregnancy poses significant challenges because the benefits and risks of anticoagulant treatment for both the mother and fetus must be carefully balanced. An interdisciplinary approach that includes obstetricians, neonatologists, physicians, and hematologists is essential to achieving optimal outcomes. This review explored the VTE updates in pathogenesis, presentation, complications, treatment options, and research gaps with proposal strategies to improve VTE outcomes and suggest further research.

Karishma

Hemophagocytic lymphohistiocytosis (HLH) is a distinct medical condition characterized by symptoms such as fever, hepatosplenomegaly, cytopenia, hypertriglyceridemia, hypofibrinogenemia, and the presence of hemophagocytosis in the bone marrow and other organs. HLH can be classified as either hereditary or secondary, linked to various infections, autoimmune disorders, or cancers. The occurrence of malaria-associated HLH in newborns is considered rare. This report details a case involving a newborn diagnosed with mixed-type malaria complicated by HLH. The diagnosis was delayed because of the rare occurrence of malaria infections in Libya, which the treating clinicians did not initially take into account. The patient received supportive care and antimalarial treatment, which yielded excellent results, and was subsequently discharged from the hospital.

Karishma

Gaucher Disease (GD) is the most common lysosomal storage disorder. The prevalence of GD is approximately 1/100,000, and type III GD accounts for 5% of cases. [1] It is an autosomal recessive disease due to a GBA gene mutation, leading to glucocerebrosidase enzyme deficiency. [1,2] Gaucher disease (GD) is categorized into three types according to clinical presentation: [3] Type I, which is non-neuronopathic and most common, particularly among Ashkenazi Jews; Type II, which is acute neuronopathic and marked by significant neurological involvement and high mortality rates; and Type III, which is subacute neuronopathic, exhibiting both systemic and neurological symptoms. In this report, we discuss a 24-year-old man from Libya diagnosed with GD type III. His diagnosis was established at the age of one due to symptoms including pallor, poor appetite, and hepatosplenomegaly. Laboratory tests indicated a hemoglobin level of 5.6 g/dL, chitotriosidase activity of 18,742 μmol/L, and an angiotensin-converting enzyme level of 251 UI/L. Genetic analysis confirmed a homozygous L444P mutation. He underwent splenectomy at the age of three, and enzyme replacement therapy (ERT) was administered intermittently with regular follow-ups until 2011. In December 2023, the patient experienced two weeks of abdominal pain, distension, and fatigue. A physical examination revealed ascites, dilated abdominal veins, and an enlarged liver and spleen.

Karishma

Hemolytic uremic syndrome (HUS) is a microangiopathic thrombotic disease, which is classified into atypical, typical, and secondary types. Thrombocytopenia, acute kidney failure, and hemolysis are the main features of HUS regardless of its type. Infection with Shiga toxin-producing Escherichia coli causes typical HUS, and gene mutations trigger atypical HUS, while secondary HUS is associated with bone marrow transplantation, autoimmunity, cancer, and other diseases. New insights into the pathogenesis of HUS have emerged over the past decades, suggesting an important role of the complement system in disease pathogenesis, which has been reinforced by the efficacy of plasma exchange and monoclonal antibodies in its treatment. In this review, we performed an updated review of HUS with a focus on understanding its pathogenesis.

Karishma

Melioidosis is an infection that causes high morbidity and mortality. Predisposing risk factors include diabetes mellitus (DM) and immunocompromised state. We report a case of septic shock secondary to bacteremia caused by Burkholderia pseudomallei in a patient who is supposed to be previously healthy and subsequently diagnosed with DM and glucose-6-phosphate dehydrogenase (G6PD) deficiency. He completed 17 days of intravenous antibiotics followed by a 12-week course of oral trimethoprim/sulfamethoxazole. We postulate that G6PD deficiency could be a risk factor for melioidosis.

Karishma

Background: Shilajit is a historically valued natural substance with promising but still preliminary scientific support for urinary and diabetic health, yet its growing popularity risks exploitation and exaggerated claims without rigorous human clinical validation. This study investigates the therapeutic effects of Yemeni Shilajit sourced from Dhamar, Ma’rib, and Raymah on hemolytic anemia experimentally induced in rabbits using phenylhydrazine. Methods: Twelve male rabbits were divided into four groups: a control group and three treatment groups, each receiving Shilajit from one of the three regions. Anemia was induced via subcutaneous injection of phenylhydrazine hydrochloride, and treatment was administered orally at a dose of 125 to 250 mg/kg twice daily. Hematological parameters—including packed cell volume (PCV), hemoglobin concentration (Hb), red blood cell (RBC) count, and glucose-6- phosphate dehydrogenase (G-6-PD) activity—were evaluated at various intervals. Results: showed that Shilajit from Dhamar and Raymah significantly increased PCV, Hb, RBC count, and G-6-PD enzyme activity (p < 0.05), suggesting notable anti-anemic effects and potential for restoring hematological parameters to near-normal levels. In contrast, Ma’rib Shilajit exhibited limited efficacy, with significant improvement only in hemoglobin levels. Phytochemical analysis confirmed the presence of essential amino acids and bioactive compounds, such as fulvic acid and dibenzo-α-pyrones, which likely contribute to Shilajit’s therapeutic action. Conclusions: The study concludes that purified Shilajit from Dhamar and Raymah holds promise as a natural remedy for hemolytic anemia, supporting its traditional use and warranting further investigation for pharmacological applications.

Karishma

Background: Preanalytical variability due to anticoagulant choice remains inadequately characterized in resource-limited tropical settings like Yemen, where environmental stressors exacerbate challenges. This study aimed to compare the stability and cost-effectiveness of K₂EDTA and K₃EDTA anticoagulants for complete blood count testing under simulated Yemeni conditions. Methods: Prospective study of 100 healthy adult male volunteers in Ad’Dla Governorate, Yemen (January–March 2025). Paired samples in K₂EDTA/K₃EDTA tubes were analyzed at baseline (T0) and after 6-hour storage at 22 ± 2°C (T6). Statistical analysis included Bonferroni-corrected repeated-measures ANOVA and paired t-tests. Results: Fresh samples showed high inter-anticoagulant concordance (ICC > 0.90). After 6-hour storage, K₂EDTA exhibited significant Mean Corpuscular Volume (MCV) reduction (Δ = −2.33 fL, p < 0 xss=removed xss=removed xss=removed> 2 hours), while K₃EDTA is preferable for immediate analysis. These findings provide preliminary guidance for hematology testing in Yemeni laboratories and similar tropical settings, pending validation in diverse populations and extreme conditions.

Karishma

Background: Sickle cell disease (SCD) is one of the most common genetic diseases worldwide, with very high prevalence rates in sub-Saharan Africa, especially Nigeria. Given the importanceand benefits of newborn screening (NBS), it is essential to assess awareness and acceptance of NBS for SCD and the factors influencing its acceptance in this region. Methods: This was a hospital-based, cross-sectional study that examined pregnant women attending the antenatal clinic for their first visit between August 1 and October 31, 2023. This antenatal clinic has an average annual attendance of 1,521 pregnant women who come for their first visit. The data obtained were analyzed using IBM SPSS Statistics (version 20), and the results were presented in prose, tables, and figures as appropriate. A level of statistical significance was set at p < 0.05. Results: Three hundred and two (302) pregnant women were recruited for the study. Though there was low awareness (13.2%), there was a high acceptance rate (96.7%) of NBS for SCD amongst the women studied. However, the type of marriage (monogamous marriage, p = 0.029) was the only factor found to have a significant relationship with the respondents’ willingness to accept NBS for SCD. Conclusions: Community education, with an emphasis on married couples, women of reproductive age, and religious leaders, should be intensified. The monogamous marriage setting may reflect marital stability, social support, or correlated socioeconomic factors on health decision-making. However, this may have different implications in different societies.

Karishma

Background: Cardiovascular diseases (CVDs) disproportionately affect conflict zones like Yemen, where diagnostic limitations persist. This meta-analysis evaluated the global prognostic utility of the red cell distribution width (RDW) and the neutrophil-to-lymphocyte ratio (NLR) as predictors of CVD and aimed to establish region-specific thresholds for low-resource settings. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines, we analyzed 75 prospective cohort studies (2014–2025) that included 201,604 adults from 142 countries. Random-effects models were used to pool hazard ratios (HRs) and the area under the curve (AUC). Results: NLR > 3.0 (HR, 2.2 [95% CI, 1.8–2.7]) independently predicted an elevated CVD risk (p < 0> 14% was associated with increased CVD risk in unadjusted analyses (HR, 2.3 [95% CI, 1.9–2.8]), this association became non-significant after adjusting for ferritin (HR, 1.02 [95% CI, 0.98–1.07]). This indicates that RDW primarily reflects iron status, emphasizing the need to measure ferritin before attributing high RDW to CVD risk. The combined RDW + NLR showed superior discriminative power (AUC, 0.82 vs. 0.71–0.74 for individual markers). Subgroup analyses revealed higher NLR cutoffs (>3.8) in HIV-endemic African populations (reflecting chronic immune activation). Sensitivity analyses revealed attenuated NLR effects in rural populations (HR, 1.9) and non-significant RDW-CVD associations when adjusting for ferritin (HR, 1.02), highlighting contextual limitations. Conclusions: While NLR stands as an independent CVD predictor, RDW > 14% must be interpreted with concurrent ferritin measurement. This is crucial to avoid misattributing CVD risk in malnutrition-endemic regions, such as Yemen, where an RDW > 15% is common. The RDW primarily reflects iron status and requires iron-status validation, especially in these high-malnutrition areas. However, caution is warranted when generalizing findings to rural settings where the CVD burden is rising fastest, given the underrepresentation of rural populations (only 16% of included studies). We strongly recommend standardized automated hematology analyzers (k > 0.85).

Karishma