A defect in urine concentrating ability occurs in individuals with sickle cell trait (HbAS). This may result from intracellular polymerization of sickle hemoglobin (HbS) in erythrocytes, leading to microvascular occlusion, in the vasa recta of the renal medulla. To test the hypothesis that the severity ofthe concentrating defect is related to the percentage of sickle hemoglobin present in erythrocytes, urinary concentrating ability was examined after overnight water deprivation, and intranasal desmopressin acetate (dDAVP) in 27 individuals with HbAS. The HbAS individuals were separated into those who had a normal a-globin genotype (aa/aa), and those who were either heterozygous (-a/aa) or homozygous (-a/-a) for gene-deletion a-thalassemia, because a-thalassemia modulates the HbS concentration in HbAS. The urinary concentrating ability was less in the aa/aa genotype than in the -a/aa or -a/-a genotypes (P < 0.05). After dDAVP, the urine osmolality was greater in patients with the -a/-a genotype than with the -a/aa genotype (882±37 vs. 672±38 mOsm/kg H20) (P < 0.05); patients with the -a/aa genotype had greater concentrating ability than individuals with a normal a-globin gene arrangement. There was an inverse linear correlation between urinary osmolality after dDAVP and the percentage HbS in all patients studied (r = -0.654; P < 0.05). A linear correlation also existed for urine concentrating ability and the calculated polymerization tendencies for an oxygen saturation of 0.4 and 0 (r = -0.62 and 0.69, respectively). We conclude that the severity of hyposthenuria in HbAS is heterogeneous. It is determined by the amount of HbS polymer, that in turn is dependent upon the percentage HbS, which is itself related to the a-globin genotype. (J. Clin.

Introduction: Severe COVID-19 can lead to critical illness, with Acute Respiratory Distress (ARDS) and Multi-organ Failure (MOF) as its primary complications, eventually followed by intravascular coagulopathy. Haematological changes are common in patients with COVID-19, which include reduced lymphocyte count and platelet count but normal white blood cell count and prolonged activated partial thromboplastin time. Using a simple test like platelet count for assessing the risk of mortality and early identification of severe cases will help in preventing the life threatening complications in patients of COVID-19. Aims and Objectives: To study trends of thrombocytopenia in patients of COVID-19 and to study the correlation between thrombocytopenia and severity of cases of COVID-19. Materials and Methods: The study was carried out in Central Clinical Laboratory in a tertiary care centre. A total of 138 random subjects who were admitted in the COVID ICU were included after they satisfied the eligibility criteria. The CBCs were analyzed on the Beckmann Coulter automated cell count analyzer with EDTA samples obtained from peripheral venipuncture of the patients. Platelet trends over the three samples were studied. Results: An average of all three platelets counts for the patients revealed an overall decreasing trend in cases of non survivors, whereas an overall upward trend was noted in the survivors. A total of 79 patients showed thrombocytopenia (platelet count less than 1.5 lakhs/mm3), during at least one of the tests.46 (33.33%) of these patients succumbed, whereas 33 (23.9%) patients survived. Decreasing trends or overall decreasing trends (Increasing then decreasing) were observed in larger number of non survivors as compared to survivors. Also increasing or overall increasing trends (decreasing then increasing) were common in the survivors. Discussion: Hematological changes are common in SARS patients. For thrombocytopenia, the possible mechanisms of SARS-CoV associated thrombocytopenia may include, 1. Direct infection of megakaryocytes and platelets potentially, inducing cell apoptosis and growth inhibition and/or 2. Immune damage of megakaryocyte progenitor cells or platelets; In addition, the lung damage in SARS patients may also play a role in inducing thrombocytopenia. Conclusion: In this study, we found that platelet count may be a simple, economic, rapid and commonly available laboratory parameter that could straightforwardly discriminate between COVID patients with and without severe disease, while the study of serial platelets counts as trends could help identifying those with a serious risk of mortality.

Introduction: Thalassemia and other hemoglobinopathies are the most common routinely encountered congenital anemias in India. Sickle cell anemia is very common, so a study to rule out all the hemoglobinopathies is essential. Aims and Objectives: The present study was conducted to diagnose various hemoglobinopathies among clinically suspected cases., the present study was conducted to diagnose various hemoglobinopathies among clinically suspected cases. Materials and Methods: A total of 212 cases cases were undertaken in this study after they met the inclusion and exclusion criteria. HPLC was performed on the samples received in the Central Clinical Laboratory of Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik, Maharashtra. Results: Out of 212 cases, 42 cases showed positivity for thalassemia or presence of abnormal hemoglobin, with 8% cases of Beta thalassemia trait, 1.88% cases of Beta thalassemia major, 4.7% cases of Sickle cell trait, 4.24% cases of Sickle cell disease and 0.94% cases of Sickle-thalassemia. Conclusions: HPLC is a fast, reliable, and cost-effective method to diagnose any suspected case of hemoglobinopathy.