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Objective: Toxoplasma infection remains as the most common cause of focal brain lesions among people living with HIV (PLHIV) despite the decline in opportunistic infections with the introduction of antiretroviral treatment. This study was conducted to provide a summary of evidence about the seroprevalence of Toxoplasma gondii and prevalence of active T. gondii infection and associated risk factors among PLHIV. Design: PRISMA guidelines were followed. Scopus, PubMed, Science Direct, and EMBASE were searched from 1997 to July 2018. All peer-reviewed original research articles describing T. gondii infection among PLHIV with different diagnostic methods were included. Methods: Incoherence and heterogeneity between studies were quantified by I2 index and Cochran's Q test. Publication and population bias were assessed with funnel plots and Egger's regression asymmetry test. All statistical analyses were performed using StatsDirect. Results: A total of 111 studies from 37 countries assessing 66,139 blood samples were included in this study. The pooled prevalence of T. gondii infection among PLHIV was 3.24% by IgM and 26.22% by molecular methods using the random-effects model. Pooled seroprevalence of T. gondii by IgG was 44.22%. There was a relationship between Toxoplasma prevalence and gender, raw meat consumption, contact with cat and knowledge about toxoplasmosis. Conclusion: High Toxoplasma seroprevalence among PLHIV observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite in case of reactivation, early identification of seropositivity for initiating prophylaxis among those with a CD4 count of <200cells/mL is recommended.

Solid tumors are a heterogeneous group of malignancies that result from out-of-control proliferation of cells. Thrombocytopenia is a common complication among patients with solid tumors that predispose them to bleeding disorders. The aim of this review article is to investigate the underlying mechanisms of the risk and incidence of thrombocytopenia in solid tumors. It can be argued that thrombocytopenia is a poor prognostic factor in solid tumors that can result from several factors such as polymorphism and mutation in some transcription factors and cytokines involved in megakaryocytic maturation or from the adverse effects of treatment. Therefore, an understanding of the exact mechanism of thrombocytopenia pathogenesis in each stage of solid tumors can help in developing therapeutic strategies to decrease bleeding complications in these malignancies.

Background and Aim: Coronaviruses disease 2019 (COVID-19), for the first time detected in Wuhan, China, rapidly speared around the world and be a Public Health Emergency of International Concern (PHEIC). The aim of the current survey is collecting laboratory findings, analysis them and reporting a specific pattern for help to COVID-19 diagnosis. Methods: To collect laboratory characteristics, we searched "PubMed" electronic database with the following keywords: "COVID-19" "2019 novel coronavirus" "laboratory findings" "clinical characteristics". Results: Once the initial searches 493 studies were yielded. After removing duplicates studies 480 studies were remained. The 12 studies obtained from the literature, of which 58.3% (7) of studies were case-control, and 41.7% remaining studies were designed as cross-sectional. Conclusion: The result of the current study showed that in the early stage of COVID-19 infection, maybe there are not significant laboratory findings, but with disease progression, the one or more than signs include increasing AST, ALT, LDH, CK, CRP, ESR, WBC, neutrophil, and decreasing Hemoglobin, lymphocyte count, eosinophil count can be seen. Elevating D-dimer and FDP are associated with ARDS development and can be used as prognostic factors. Keywords: COVID-19; laboratory findings; prognostic factors

This review compared coronavirus disease 2019 (COVID-19) laboratory findings, comorbidities, and clinical outcomes in patients from the general population versus medical staff to aid diagnosis of COVID-19 in a more timely, efficient, and accurate way. Electronic databases were searched up to 23 rd March, 2020. The initial search yielded 6,527 studies. Following screening, 24 studies were included [18 studies (11,564 cases) of confirmed COVID-19 cases in the general public, and 6 studies (394 cases) in medical staff] in this review. Significant differences were observed in white blood cell counts ( p < 0.001), lymphocyte counts ( p < 0.001), platelet counts ( p = 0.04), procalcitonin levels ( p < 0.001), lactate dehydrogenase levels ( p < 0.001), and creatinine levels ( p = 0.03) when comparing infected medical staff with the general public. The mortality rate was higher in the general population than in medical staff (8% versus 2%). This review showed that during the early stages of COVID-19, laboratory findings alone may not be significant predictors of infection and may just accompany increasing C-reactive protein levels, erythrocyte sedimentation rates, and lactate dehydrogenase levels. In the symptomatic stage, the lymphocyte and platelet counts tended to decrease. Elevated D-dimer fibrin degradation product was associated with poor prognosis.

BackgroundAlloantibody production is one of the most challenging complications in transfusion‐dependent thalassaemia patients. Haemolytic anaemia, an increase in blood consumption, difficulty in haematopoietic stem cell transplantation and reduced quality of life are consequences of alloimmunisation. The most predisposed antigens (Ags) for alloantibody development are Rh and Kell blood group Ags.ObjectiveThe aim of the present study is to evaluate any correlation between HLA‐DRB1 alleles and Rh and Kell alloantibodies.Materials and MethodsFifty‐two non‐responders (control) and 54 responders (case) were enrolled in this study. Alloantibody detection was performed using the tube method. Genotyping of HLA‐DRB1*01 and HLA‐DRB1*15 was conducted by single‐specific primer‐polymerase chain reaction.ResultsIn the responder group, 77.8% were hyper‐responders (more than one alloantibody), and only 22.2% were mono‐responders. Most detected alloantibodies were Anti‐K (94.4%), followed by Anti‐E (64.8%), Anti‐C (29.6%) and Anti‐D (25.9%). There was a significant difference in HLA‐DRB1*15 between responder and non‐responder groups, 73.7% vs 26.3%, respectively. (P = .029, OR = 3.290; 95%CI). Our results showed that HLA‐DRB1*15 was more frequent in hyper‐responders than mono‐responders (92.9% vs 7.1%) (P = .007). The greatest HLA‐DRB1*15 was seen in Anti‐K (P = .014, odds ratio [OR = 3.784]; 95% confidence interval [CI]) and Anti‐E (P = .011, OR = 3.609; 95%CI) alloantibodies. There is no association between HLA‐DRB1*01 and alloimmunisation.ConclusionOur findings showed that there is a significant correlation between HLA‐DRB1*15 and Anti‐K and Anti‐E alloantibodies. These findings can be useful in detecting susceptible thalassaemic patients and improving transfusion management.

We evaluated the most common indices to compare their sensitivity and specificity to introduce the most sensitive and specific index. We systematically searched five international indexing databases up to Dec 2018. For each index, we measured the diagnostic odds ratio (DOR), as well as summary ROC (SROC) curve which was used to compare the performance of each index. Deeks̕ tests of all discriminant indices indicated that there is no potential publication bias. The area under curves (AUCs) of all discriminant indices indicate overall good differential performance. The M/H ratio index was more sensitive and specific compared to other studied indices. In this meta-analysis, the M/H ratio index was more potential to discriminate iron deficiency anemia (IDA) from thalassemia trait. However, we cannot use this index alone to achieve the final diagnosis. The capability of this index to discriminate IDA from thalassemia trait must be used alongside with the common laboratory procedure to ensure the final differentiation.

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