Somatic growth was stunted in yearling brook trout (Salvelinus fontinalis) maintained for up to 73 d in pH 4.5. Plasma cortisol level increased in pulses after 1.5 h (from 10 to 82.3 ng∙mL−1) on days 4 (46 ng∙mL−1) and 15–30 (20–25 ng∙mL−1) of acid treatment. Interrenal nuclear hypertrophy and cell hyperplasia occurred respectively on days 4 and 15. Electron microscopic observations revealed that the somatotropes and thyrotropes were atrophic for about half of the experimental period whereas the corticotropes displayed sustained hypertrophy. Plasma glucose and amino acid levels rose simultaneously by 300–600 and 130%, respectively, from day 4 of acid exposure. Hepatic L-alanine aminotransferase activity increased on day 30 just as plasma protein concentration began to decline. When adrenalin and cortisol acetate were administered to trout maintained in neutral pH to raise circulating cortisol levels from 10–20 to 1876 ng∙mL−1, blood glucose remained normal up to 6 d after treatment. These results suggested that acid stress suppressed somatotropin, thyrotropin, and indirectly thyroid hormone secretion but stimulated the pituitary–interrenal axis, leading to inhibition of protein synthesis and accumulation of amino acids in the circulation. The elevation of blood sugar level was caused by some as yet unidentified factors.

Background: The aetiology of thrombocytopenia is important in treatment and management of the condition. Most platelet parameters that are routinely analysed in the diagnostic laboratory have not proven useful in identifying the aetiology while specialised assays suffer from poor standardisation and lack of agreement between laboratories. The immature platelet fraction (IPF), which indirectly provides a measure of bone marrow function is showing promise as a valuable marker of thrombopoietic responses. Objectives: To determine whether the IPF could effectively identify specific underlying aetiologies of thrombocytopenia in a large thrombocytopenic cohort, to allow for quicker, more effective management of the condition. Patients and Methods: The IPF was analysed in a large cohort of 637 thrombocytopenic patients and 171 healthy control patients on the Sysmex XN 10 haematology analyser using the specialised fluorescence optical analysis. The thrombocytopenic patients were divided into six cohorts based on aetiology. Results: The IPF%, was significantly higher in cases of increased platelet consumption (median=9.55, min=1.1, max= 77.9), or pseudothrombocytopenia (median=13.1, min=0.4, max=28.8) compared with control (median=4.2, min=1.3, max=12.8). Furthermore, the IPF% was also able to identify idiopathic thrombocytopenic purpura (ITP) (P<0.05) (median=13.4, min=2.8, max=77.9) from other causes of increased platelet consumptive disorders (Infection; median=6.4, min=1.1, max=21.6; haemorrhage, median=8.9, min=1.2, max=20.2). Conclusion: Using this large thrombocytopenic cohort, the IPF% has been shown to be of significant diagnostic value, providing a useful rapid test in the aetiological investigation of platelet disorders.

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Objective: To determine frequency of thyroid dysfunction among patients of chronic hepatitis C receiving combined pegylated interferon alpha and ribavirin therapy. Study Design: Cross sectional study. Place and Duration of Study: Department of Medicine, Military Hospital Rawalpindi, from Jan to Jul 2017. Methodology: One hundred and twenty patients, aged 18–60 years from both genders, with established hepatitis C were included; while the patients with decompensated liver disease, previous antiviral treatment, pre-existing thyroid, autoimmune or severe cardiopulmonary disease and on immuno-suppressants or steroids were excluded. After formal informed consent, they were prescribed 24 weeks pegylated interferon alpha-2 (3 million units subcutaneously thrice weekly) and oral ribavirin (1000–1200 mg daily) therapy. After 12 weeks, serum thyroid stimulating hormone, free thyroxine and triiodothyronine levels were determined by chemiluminescence technique. Results: Out of 120 patients, 100 (83.33%) were males and 20 (16.67%) were females with male to female ratio of 5:1. Mean thyroid stimulating hormone levels at baseline and 12 weeks were 2.86 ± 1.03uiu/ml and 2.16 ± 0.79 uiu/ml respectively. Mean triiodothyronine levels at baseline and 12 weeks were 3.27 ± 1.31pg/ml and 2.69 ± 1.01 pg/ml respectively. Mean thyroxine levels at baseline and 12 weeks were 1.26 ± 0.38 pg/ml and 1.07 ± 0.53 pg/ml respectively. Frequency of thyroid dysfunction was found in 40 (33.33%) patients. Conclusion: Frequency of thyroid dysfunction among hepatitis C patients receiving combined pegylated interferon alpha and ribavirin therapy is quite high.