Introduction: Increased monocyte percentage and monocyte anisocytosis were suggested as new markers for den- gue fever detection. This study aims to investigate and evaluate monocyte volume standard deviation (MoV-SD) and monocyte percentage (Mono %) parameters using Coulter automated haematology analyser as screening parameters in discriminating between dengue infection and other febrile illness. Methods: A cross-sectional laboratory analysis using suspected dengue fever patients were included in this study. The study was conducted in the Department of Pathology, Hospital Tuanku Jaafar Seremban from June 2016 until June 2017. Patients were classified into dengue positive and dengue negative based on dengue IgM and NS1 result. The diagnostic performance of MoV-SD and Mono % was analysed by receiver operating characteristic (ROC) curve analysis. The cut-off value of the MoV-SD and Mono % was determined and evaluated with the validation group. Chi-square test was used to assess the as- sociation between the parameters. Results: 88 (48.4%) from 182 samples were confirmed to have dengue infection. ROC curve analysis showed Mono % at cut off value of 10.5 % with area under the curve (AUC) of 0.869 with 84.1% sensitivity and 84% specificity (95% CI: 0.812-0.925) and MoV-SD cut off value at 22.2 (AUC 0.776, 80.7% sensitivity, 61.7% specificity, 95% CI: 0.709-0.843) are an excellent parameters in separating dengue positive and dengue-negative patients. A cut-off value of 10.5 of Mono % and 22.2 of MoV-SD were applied to the validation group showed 83.1%, 66.4% sensitivity and 84.9%, 77.3% specificity respectively. Conclusion: MoV-SD and Mono
% parameters are a potential parameter for the screening of dengue infection in acute febrile illness patients with good specificity and sensitivity.
Inflammation and endothelial dysfunction are key components in atherogenesis. Should the status of these pro-atherogenesis factors be enhanced during prolonged confined space travel, specific countermeasures need to be instituted to prevent these processes to ensure safe outcome for astronauts during space expeditions. Six crew members were exposed to prolonged, confined isolation for 520 days. Standard exercise and diet regime were instituted throughout isolation phase. Age and gender-matched healthy, free living controls were recruited in parallel. Serial serum and whole blood were analysed for biomarkers of inflammation (hsCRP and IL-6) and endothelial activation (sICAM-1, sVCAM-1 and E-selectin). Flow-mediated dilatation (FMD) of the artery was performed following the standard protocols set by the International Brachial Artery Reactivity Task Force by trained personnel. There was decreased sVCAM-1 concentration in crew members compared to baseline. However, there was significant decrease in percentage dilatation from baseline in FMD of the brachial artery in the crew members. Percent change increment was observed in hsCRP while percent change reduction was seen in sVCAM-1. The enhanced inflammation and reduced endothelial function could possibly be attributed to the rigorous exercise instituted throughout the confinement period. Furthermore, possible haemoconcentration as a result of psychosocial stress and/ or exercise-induced physiological response could further explain elevations in hsCRP, and unlikely pathological. Furthermore, endothelial activation was attenuated during isolation, suggesting that the diet and exercise program instated throughout the period improved endothelial function.
Asparaginase-induced hypertriglyceridemia can have a spectrum of clinical presentations, from being asymptomatic to having life-threatening thrombosis or hyperviscosity syndrome. At present, there is no recommendation on routine lipid monitoring during asparaginase-containing treatment phase, nor a standardized guideline on its management. Two cases are presented here to illustrate the effects of concurrent infection on asparaginase-induced hypertriglyceridemia in patients with high-risk ALL and the use of SMOFlipid infusion as a treatment option in an acute situation.