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Introduction: The spectrum of haematological and non haematological disorders is vast in various age groups. Complete blood counts and other routine laboratory tests are not always sufficient to diagnose these diseases. Bone marrow examination plays an important role in diagnosing their underlying causes. Aim: To analyse the spectrum of various haematological and non haematological disorders reported in Bone Marrow Aspiration (BMA) and compare them with Bone Marrow Trephine Biopsy (BMB) and Flow Cytometry (FCM) findings where applicable. Materials and Methods: A one-year cross-sectional study was conducted in the Department of Clinical Pathology, PGIMS, Rohtak, Haryana, India from April 2022 to March 2023. A total of 518 consecutive BMA samples were morphologically analysed. Comparative evaluations were performed among BMA, BMB, and FCM where applicable. Diagnostic accuracy was calculated, and the findings of discordant cases were tabulated. Definitive diagnosis of lymphoma/leukaemia and Paroxysmal Nocturnal Haemoglobinuria (PNH) cases were made using FCM. Results: The patients' ages ranged from three months to 86 years, with a mean age of 38.4 years. The male to female ratio was 1.3:1, with a slight male predominance. The highest number of cases were of anaemia {183 (35.3%) and 164 (31.7%), respectively} and leukaemia {128 (24.7%) and 134 (25.9%), respectively}, followed by normal marrow studies {39 (7.5%) and 32 (6.2%), respectively} and megakaryocytic thrombocytopenia {24 (4.6% in each} in both BMA and biopsy. Among anaemia cases {183 and 164 cases in BMA and BMB}, the majority were of the megaloblastic type {62 (33.8%) and 54 (32.9%), respectively}, followed by hypoplastic/aplastic type {40 (21.8%) and 50 (30.5%), respectively}. In cases of leukaemia (128 and 134 cases in BMA and BMB), acute leukaemia cases (76 (59.4%) and 82 (61.2%), respectively} outnumbered chronic leukaemia cases {52 (40.6%) and 52 (38.8%), respectively} in both BMA and BMB. The concordance and discordance rate between BMA and BMB were 87.6% (419 cases) and 12.4% (59 cases), respectively. Diagnosis was exclusively made by BMB in cases of myelofibrosis, granulomatous disease, and Hodgkin's lymphoma. Conclusion: BMA cytology is a relatively safe and mildly invasive technique for evaluating various haematological and non haematological disorders with better preservation of cellular morphology. However, in cases with dry/blood taps and focal marrow involvement, BMB should be performed, as it shows well-preserved marrow architecture with all its cellular and stromal components. FCM is a definitive diagnostic modality for further categorisation of acute leukaemia and Chronic Lymphoproliferative Disorders (CLPD). [ABSTRACT FROM AUTHOR]

Between 2016 and 2020, the number of patients and the overall percentage compared to all hospitalizations have increased from 0.6% in 2016 to 1.0% in 2020 ( I p i SB trend sb < 0.01). In their article entitled "Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis", Luccarelli et al. found various differences in patient characteristics and outcomes.[1] As they further mentioned "reduction of the use of physical restraints has been a target for quality improvement interventions, and has led to interdisciplinary quality improvement efforts"[1], we used data from the 2016-2020 National Inpatient Sample[2] to evaluate for trends in physical restraint status in the USA among patients of ages 18 and above. Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis. [Extracted from the article]

It is known that some organic materials show a good capacity for selective removal of Cr(VI) from contaminated water; however, the exact mechanism of such removal has yet to be investigated and established. In this study, coconut husk, a waste material with no or low cost, has been used as a representative material to investigate the exact mechanism of Cr(VI) removal by organic matter from synthetic wastewater. The investigation has been carried out in two significant stages. First, the adsorption phenomenon was studied using batch kinetic and column studies to determine the isotherms and kinetic models and effects of process parameters like solution pH and contact time. 100% Cr(VI) removal was achieved at pH 2 within 30 min at a stirring rate of 300 rpm. Although an impressive adsorption capacity of 222.22 mg/g was calculated using the Langmuir model, there was a poor fit of the observed data with the known adsorption models, leading to the inference that the mechanism of removal involved processes other than simple adsorption. The virgin and exhausted material were further characterized using field emission-scanning electron microscope (FE-SEM), thermal analysis, Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) and X-ray photoelectron spectroscopy (XPS). From the characterization results, it was found that Cr(VI) was first adsorbed at the functional groups followed by oxidation of major components like hemicelluloses, cellulose, and lignin, present in the adsorbent, resulting in the formation of ethers, carboxylic groups, and other carbonyl functionalities. Cr(VI) itself got reduced to Cr(III) and precipitated as Cr(OH) 3 inside the pores of the adsorbent. The study conclusively established that Cr(VI) removal by organic matters such as coconut husk is essentially a sorption coupled redox process. [Display omitted] • Cr(VI) removal was investigated by coconut husk as a representative biosorbent. • 100% Cr(VI) removal was achieved at pH 2 in batch adsorption study. • Cr(VI) was reduced to Cr(III) while the components of coconut husk were oxidized. • Sorption coupled with redox reaction was found responsible for Cr(VI) removal. • The removal mechanism may inspire the design of high-capacity adsorbents for Cr(VI). [ABSTRACT FROM AUTHOR]

This document is a letter published in the Annals of Hematology that discusses factors associated with inpatient mortality during daunorubicin and cytarabine induction in adults with acute myeloid leukemia (AML). The authors conducted a study using the 2016-2020 National Inpatient Sample (NIS), which is a large database of hospital records in the USA. They found that several patient characteristics and comorbidities were associated with higher or lower chances of inpatient mortality. Factors such as weekend admissions, cirrhosis, obesity, chronic kidney disease, and age over 60 were associated with higher mortality, while being Hispanic, having a larger bed size, and having diabetes or hypertension were associated with lower mortality. The study also found that complications such as septicemia, acute kidney injury, and cardiogenic shock were common during induction therapy and increased mortality. [Extracted from the article]

Juvenile arthritis (JA) is an autoimmune condition affecting children. We used the 2017 National Inpatient Sample (NIS) to evaluate the impact of JA in the United States. The admission data were converted to weighted form and patients between the ages of 0 and 18 (inclusive) were used in our study. 560 weighted cases were found in 2017. It was more common in females than males (340 females, 220 males), Whites (235 cases), and Medicaid covered 61.6% of all patients with JA (345 cases). The total hospital charges were $25,147,389 while the mean length of stay (LOS) was 4.55 days. The highest number of cases was reported in April 2017. [ABSTRACT FROM AUTHOR]